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目的 :探讨平板运动试验中冠心病 (CHD)患者与非CHD患者QTpd、QRS宽度和QRS额面电轴变化的意义。方法 :对 6 6例经冠状动脉造影和活动平板检查的患者 ,根据冠状动脉病变程度分为非CHD组和CHD组 ,观察运动试验前后QTpd和QRS宽度的变化 ;CHD组根据病变所累及的血管分为 3个亚组 ,CHD组 1为左前降支病变有或无左回旋支病变 ,CHD组 2为右冠病变有或无左回旋支病变 ,CHD组 3为 3支病变或左前降支病变有或无右冠病变 ,观察运动试验前后QRS额面电轴的改变。结果 :①运动前CHD组与非CHD组QTpd、QRS宽度差异无显著性意义 (P >0 .0 5 )。②运动后非CHD组QTpd无明显改变 (P >0 .0 5 )、QRS宽度变窄 (P <0 .0 1) ,CHD组QTpd增大、QRS宽度延长 (P <0 .0 1)。③运动后 ,非CHD组QRS额面电轴无明显改变 (P >0 .0 5 ) ,CHD组 1QRS额面电轴向左偏 (P <0 .0 1) ,CHD组 2QRS额面电轴向右偏 (P <0 .0 1) ,CHD组 3QRS额面电轴改变无统计学意义 (P >0 .0 5 )。结论 :运动导致的QTpd增大、QRS时限延长及QRS额面电轴的改变对CHD及其所累及的血管的定位诊断有较大的意义
Objective: To investigate the significance of QTpd, QRS width and QRS frontal plane axis in patients with coronary heart disease (CHD) and non-CHD during treadmill exercise test. Methods: Sixty-six patients underwent coronary angiography and active treadmill test were divided into non-CHD group and CHD group according to the degree of coronary artery lesion. The changes of QTpd and QRS width before and after exercise test were observed. According to the vascular involvement Divided into three subgroups, CHD group 1 with or without left circumflex coronary artery lesion, CHD group 2 with or without left circumflex coronary artery disease, CHD group 3 with 3 lesions or left anterior descending artery disease With or without right coronary artery lesions, observed before and after exercise test QRS frontal plane axis changes. Results: ① There was no significant difference in QTpd and QRS width between CHD group and non-CHD group before exercise (P> 0.05). ② QTpd did not change significantly in non-CHD group after exercise (P> 0.05), QRS width narrowed (P <0.01), QTpd increased in CHD group, prolonged QRS width (P <0.01). ③ After exercise, there was no significant change in QRS frontal axis (P> 0.05) in CHD group, left axial offset of 1QRS in CHD group (P <0. 01), 2QRS frontal axis in CHD group Right deviation (P <0.01), CHD group 3QRS frontal plane axis change was not statistically significant (P> 0.05). Conclusion: The increase of QTpd caused by exercise, the prolongation of QRS duration and the change of plane axis of QRS have a great significance for the localization diagnosis of CHD and its involved vessels