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目的 研究QTc离散度 (QTcd)对冠心病的诊断价值及观察经皮冠状动脉腔内成形 (PTCA)和支架术对其的影响。方法 15 0例接受了冠状动脉造影术者 ,根据其结果分为 3组 ,即正常组 (n =44 ) ,有易患因素而冠脉造影正常组 (n =60 )和冠心病组 (n =46)。测量标准 12导联心电图 ,计算其校正的QT离散度 (QTcd) ,并测量其中 2 0例接受了PTCA及支架术的患者术前 ,术后 2h和 7d的QTcd。按临床流行病学诊断试验方法计算QTcd对冠心病诊断的敏感性、特异性、准确性。结果 冠心病组QTcd显著大于正常组〔( 70 5± 8 2 )ms对 ( 4 4 3± 7 6)ms ,P <0 .0 1〕和有易患因素而冠脉造影正常组〔( 70 5± 8 2 )ms对 ( 4 4 8± 8 0 )ms ,P <0 .0 1〕 ,PTCA及支架术后 2h、7d的QTcd均小于术前〔( 76 2± 8 1)ms对 ( 4 0 2± 4 6)ms,P <0 .0 1;( 76 2± 8 1)ms对 ( 3 8 9± 4 3 )ms,P <0 .0 1〕。QTcd≥ 5 0ms为标准 ,诊断冠心病的敏感性 87 0 %、特异性 5 1 9%、准确性62 7%。结论 QTcd离散度增加对冠心病诊断有一定临床价值
Objective To investigate the diagnostic value of QTc dispersion (QTcd) in coronary heart disease and to observe the effect of percutaneous transluminal coronary angioplasty (PTCA) and stenting. Methods One hundred and fifty patients undergoing coronary angiography were divided into 3 groups according to their results: normal group (n = 44), patients with predisposition for coronary angiography (n = 60) and coronary heart disease group (n = = 46). The standard 12-lead electrocardiogram was measured to calculate the corrected QT dispersion (QTcd), and QTcd of 20 patients before and 2 and 7 days after PTCA and stenting was measured. Calculate the sensitivity, specificity and accuracy of QTcd in the diagnosis of coronary heart disease by clinical epidemiological test. Results The QTcd in coronary heart disease group was significantly higher than that in the control group [(70 5 ± 82) ms vs (443 ± 7 6) ms, P <0.01] 5 ± 8 2 ms vs 4 48 ± 80 ms, P 0 01), and the QTcd values at 2 h and 7 d after PTCA and stent operation were significantly lower than those before operation (76 2 ± 8 1 ms vs 4 0 2 ± 4 6) ms, P <0 1; (76 2 ± 8 1) ms versus (3 8 9 ± 4 3) ms, P <0.01). QTcd ≥ 5 0ms for the standard diagnosis of coronary heart disease, the sensitivity of 87 0%, specificity of 5 1 9%, accuracy 62 7%. Conclusion The increased QTcd dispersion has certain clinical value in the diagnosis of coronary heart disease