摘要
目的 本文通过对 10 0例平板运动试验的患者分析其J点后 6 0ms及J点后 80ms处测量ST段变化对评价平板运动试验结果的影响进行探讨。 方法 胸闷、胸痛可疑冠心病的患者共 10 0例 ,男性 5 4例 ,女性 4 6例 ,年龄 31～ 70岁 ,平均5 2岁 ,全部患者均行平板运动试验 ,并同时监测血压。阳性诊断标准为运动中出现典型心绞痛 ,运动中和恢复期出现ST段呈水平或下垂型下移≥ 0 1mV ,运动中出现收缩压下降≥ 10mmHg。通过目测方法 ,对 10 0例患者分别采用J点后 6 0ms及 80ms测定ST段偏移情况。 结果 全部采用J点后 80ms所得阳性结果有 2 6例 (男 18例 ,女 8例 ) ,J点后 6 0ms所得阳性结果有 34例 (男 2 4例 ,女 10例 )。其中J点后 6 0ms及 80ms所得结果不同的有 8例 ,均是J点后 6 0ms评定够阳性标准 ,而 80ms评定不够阳性标准。其中 6例是采用J点后 80ms,心率加快导致J点落在T波的升支上 ,由此得到假阴性结果。如果采用J点后 6 0ms则可避免得到假阴性结果。另 2例是ST段呈斜上型下移。J点后 6 0ms及 80ms所得结果完全相同者多为ST段呈水平型下移。 结论 J点后 6 0ms比 80ms更容易避免伪差等所致的假阴性结果 ,对冠心病诊断更灵敏。
Objective To investigate the influence of ST segment measurement at 60 milisecond and 80 milisecond on the diagnostic value of exercise electrocardiogram examination. Methods 100 cases of patients with chest compressing and/or angina underwent exercise electrocardiogram examination and blood pressure measurement. The drifting of ST segment was measure respectively at 60 ms and 80 ms behind J point by eyes. Results 26 positive cases were detected when measured at 80 ms behind J point, while 34 cases were detected when at 60 ms. Different results were obtained in 8 cases when measured at different position,which were defined as positive results at 60 ms behind J point,while not at 80 ms. Most of the coincident results demonstrated horinzontally decreasing of ST segment. Conclusion Exercise electrocardiogram exhibited higher sensitivity for diagnosis of coronary artery disease when measured at 60 ms behind J point than at 80 ms.
出处
《空军总医院学报》
2004年第2期74-75,共2页
Journal of General Hospital of Air Force,PLA
关键词
心电描记术
运动试验
冠状动脉疾病
诊断
Electrocardiography
Exercise test
Coronary disease/diagnosis
