心电向量图运动试验前后QRS环时间改变对冠心病诊断价值

目的探讨心电向量图运动试验前后QRS环时间对冠心病辅助诊断价值。方法选择行冠状动脉造影术的91例确诊或疑诊冠心病病人,在术前2 d内行心电向量图运动试验,测量运动前后QRS环时间的改变,并与冠状动脉造影的结果进行对比分析。结果冠心病组运动后QRS环时间延长,而冠状动脉造影正常组运动后QRS环时间缩短,两组QRS环时间变化均在运动后即刻最为显著。用BAZETT公式校正的QRS环时间,无论是冠心病组还是冠状动脉造影正常组,运动后均延长,其中以冠心病组延长为著(t=20.2,P<0.01)。结论心电向量图运动后QRS环时间改变,可在ST段等指标的基础上提高对冠心病诊断的准确性;心电向量图QRS环时间测算容易,重复性好,值得在临床推广。

SIGNIFICANCE OF THE CHANGES IN QRS LOOP DURATION AFTER THE TREADMILL EXERCISE TEST IN THE DIAGNOSIS OF CORONARY HEART DISEASE

Objective To assess the significance of changes in QRS loop duration after the treadmill exercise test with continuous vectorcardiogram monitoring in the diagnosis of coronary heart disease.MethodsTreadmill exercise tests were conducted on patients with coronary heart disease(group A) and suspected cases(group B;total n=91) for two days,followed by coronary arteriography.Continuous monitoring of the vector-cardiogram was performed during the exercise,and changes in the duration of QRS loop were measured and compared with the results of the arteriography.ResultsAfter the test,the duration of QRS loop was prolonged in group A,but shortened in group B,the corresponding changes were most obvious just after the exercise.The QRS loop duration corrected with BAZETT formula(QRSc) was also prolonged both in groups A and B,furthermore,the prolongation of QRSc in group A was more prominent than that in group B(t=20.2,P<0.01).ConclusionMeasurement of the changes in QRS loop duration after the treadmill exercise test can increase the accuracy in the diagnosis of coronary heart(disease);which is easy-doing and repetitive and worth of the clinical promotion.