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目的 探讨区域性QT间期差值 (QTrd)能否作为鉴别扩张型心肌病和缺血性心肌病引起的ST -T改变的一项指标。方法 将 6 4例因体表心电图出现ST段异常改变 ,经冠状动脉造影确诊为缺血性心肌病或扩张型心肌病的患者分为缺血性心肌病组和扩张型心肌病组 ,把体表心电十二导联的心电图分为Ⅰ、AVL ,Ⅱ、Ⅲ、AVF ,V2～ 4,V5～ 6四个区域测量QTrd并进行分析比较。结果 在Ⅰ、AVL区域 ,各组都有部份QTrd≥ 4 0ms;Ⅱ、Ⅲ、AVF ,V2～ 4,V5～ 6三个区域 ,有一个区域的QTrd≥ 4 0ms的百分比 ,在扩张型心肌病组为81% ,缺血性心肌病组无一例大于 4 0ms。结论 扩张型心肌病时 ,如心电图出现ST异常改变 ,在Ⅱ、Ⅲ、AVF ,V2～ 4,V5～ 6这三个区域中 ,有一区域的QTrd >4 0ms ,则心肌扩张引起缺血的可能性大 ,如这三个区域中的QTrd都小于 4 0ms ,可能为冠状动脉病变引起心肌缺血的表现。
Objective To investigate whether regional QT interval difference (QTrd) can be used as an index to identify ST-T changes caused by dilated cardiomyopathy and ischemic cardiomyopathy. Methods Sixty-four patients with abnormal ST-segment due to body surface electrocardiogram and ischemic cardiomyopathy or dilated cardiomyopathy diagnosed by coronary angiography were divided into ischemic cardiomyopathy group and dilated cardiomyopathy group, Table ECG electrocardiogram twelve lead is divided into Ⅰ, AVL, Ⅱ, Ⅲ, AVF, V2 ~ 4, V5 ~ 6 measurement QTrd four regions and analysis and comparison. Results In the Ⅰ and AVL regions, QTrd≥4 0ms in each group, QTrd≥4 0ms in one of Ⅱ, Ⅲ, AVF, V2 ~ 4 and V5 ~ 6 regions. In dilated myocardium Disease group was 81%, no case of ischemic cardiomyopathy more than 4 0ms. Conclusions In patients with dilated cardiomyopathy, if the ECG shows abnormal changes of ST, in a region of Ⅱ, Ⅲ, AVF, V2 ~ 4 and V5 ~ 6, there is a region with QTrd> 4 0ms, then the myocardial expansion may cause ischemia Sex, such as the QTrd of these three regions are less than 4 0ms, may be caused by coronary artery disease myocardial ischemia performance.