QRS波时限延长在冠心病患者运动试验中的意义

目的　探讨冠心病患者运动试验中QRS波时限变化的意义。方法　分析经冠脉造影证实的 6 2例冠心病患者和 16例冠状动脉造影正常者运动试验前、后QRS波时限变化。结果　冠脉正常组平板运动试验 (ETT)后QRS波时限较运动前缩短 (P <0 0 5 ) ;冠心病组ETT后QRS波时限较运动前延长 (P <0 0 1) ;不同冠状动脉病变程度患者ETT后QRS波时限间差别有显著性差异 (P <0 0 5 )。以ETT后QRS波时限延长为异常 ,其诊断冠心病的敏感性为72 6 % ,特异性为 93 8% ,准确性为 97 8%。结论　冠心病患者ETT后QRS波时限延长是心肌缺血的一个标志 ,QRS波时限是运动试验中诊断冠心病心肌缺血敏感而特异的指标。

The Significance of QRS Duration during Treadmill Test in Patients with Coronary Heart Disease

Objective To investigate the significance of QRS duration during treadmill test in patients with coronary artery disease.Methods QRS duration was analyzed before and after treadmi11exercise test in 62patients with coronary artery disease and 16 patients with normal coronary arteries identified by coronary angiography.Results QRS duration was obviously shorter right after exercise than those before exercise (P<0.05) in normal group,and it was longer in coronary group (P<0.01);Exercise induced QRS duration prolongation was directly related to the number of diseased vessels.QRS pro1ongation had a diagnosis of 72.6%,specificity of 93.8%,accuracy of 97.8%,for the diagnosis of coronary artery disease.Conclusion Exercise-induced QRS prolongation after ETT in patients with coronary artery disease is a marker of exercise-induced myocardia1 ischemia;QRS duration during exercise treadmi11 test could be used as a sensitive and specific index for the diagnosis of coronary artery disease.