冠心病患者平板运动试验中Ｑ－Ｔｃ变化山西医学院第二附属医院心内科（０３０００１）王瑞英山西医学院第二附属医院综检科张风娥，陈秀庭平板运动试验迄今仍为临床诊断冠心病广泛应用的方法，判断运动试验的标准多数仍采用ＳＴ段参数，近年来为提高运动试验对冠心病的检出率，运动后心电图Ｑ－Ｔｃ改变受到极大重视。本文报道了我院１９９２年１月～１９９３年２月正常人和冠心病平板运动试验阳性患者运动前后Ｑ－Ｔｃ间期变化，旨在评价其对冠心病的诊断价值。资料与方法１。病例选择：正常组５０例，男３９例，女１１例，年龄３１～７５岁（平均５３．５岁）。均经临床体检、心电图检查、胸部透视及超声心动图检查除外心脏器质性疾病。冠心病组５０例，男３８例，女１２例，年龄３９～６９岁（平均５５．２岁）。冠心病组中，心绞痛４９例，陈旧性心肌梗１例。均经临床体检、心电图检查、心肌酶学检查符合冠心病诊断的ＷＨＯ标准，且平板运动试验阳性，两组均除外电解质异常及服用影响Ｑ－Ｔｃ间期药物的患者。２．方法：行次极量平板运动试验，于运动前、运动结束后即刻、２分钟、４分钟、６分钟时记录心电图。选择ＱＲＳ波及Ｔ波振幅较高的导联（尤其ｑ波导联）。连续测量３～６个Ｑ－Ｔ间期及Ｒ Q-Tc changes in treadmill exercise test in patients with coronary heart disease Second Affiliated Hospital of Shanxi Medical College Cardiology (030001) Wang Ruiying Second Affiliated Hospital of Shanxi Medical University, Zhang F E, Chen Xiu Ting treadmill exercise test is still widely used in clinical diagnosis of coronary heart disease Methods to determine the majority of the standard exercise test is still using ST segment parameters in recent years to improve the exercise test on the detection rate of coronary heart disease, exercise Q-Tc ECG changes have received great attention. This article reports our hospital from January 1992 to February 1993 normal subjects and coronary heart disease treadmill exercise test before and after Q-Tc interval changes in order to evaluate its diagnostic value of coronary heart disease. Data and methods 1. Case selection: 50 cases of normal group, 39 males and 11 females, aged 31 to 75 years (mean 53.5 years). Except clinical examination, electrocardiogram examination, chest fluoroscopy and echocardiography except cardiac organic disease. Coronary heart disease group of 50 patients, 38 males and 12 females, aged 39 to 69 years (mean 55.2 years). Coronary heart disease group, 49 cases of angina pectoris, old myocardial infarction in 1 case. Clinical examination, electrocardiogram examination, myocardial enzymology examination conformed to the WHO standard for diagnosis of coronary heart disease, and the treadmill test was positive. Except for electrolyte abnormalities in both groups and patients taking Q-Tc medications. 2. Methods: Excess treadmill exercise test, before exercise, immediately after exercise, 2 minutes, 4 minutes, 6 minutes ECG recording. Select QRS wave and T wave amplitude higher lead (especially q wave guide). Continuous measurement of 3 to 6 Q-T interval and R