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目的研究平板运动试验过程中诱发的一过性高耸T波的变化特征及临床意义及其与冠状动脉造影结果的相关性。方法分析2100例接受平板运动试验者中,12例运动中及运动后发生的一过性巨大高耸T波患者的冠状动脉造影。结果运动中发生高耸T波患者中,10例开始于运动中1～8(平均5.17)min,2例发生于运动结束后2～3min。高耸T波持续2～6(平均3.8)min。高耸T波出现在V2、V3导联11例(91.7%)、V4导联9例(75%),下壁II、III、aVF导联3例,V1导联1例。T波幅度V2导联1.0～2.3(平均1.55)mV,V3导联0.5～2.0(平均1.52)mV,V4导联0.8～1.6(平均1.0)mV,下壁II、III、aVF导联0.5～0.9(平均0.7)mV,运动中发生心绞痛9例,1例于T波高耸2min时突发心室颤动,经电击复律。分析12例冠状动脉造影术结果,前降支病变8例(66.7%),前降支加右冠状动脉病变2例,右冠状动脉及三支病变各1例。行PTCA术10例,支架植入术8例。结论平板运动试验诱发巨大高耸T波是判断冠状动脉病变的可靠的阳性标准。
Objective To investigate the characteristics and clinical significance of transient T-wave induced by treadmill exercise test and its correlation with coronary angiography. Methods The coronary angiography of 2,100 patients with treadmill exercise was analyzed in 12 patients with transient giant towering T wave during and after exercise. Results Of the patients with towering T wave during exercise, 10 cases started from 1 to 8 (average 5.17) min in exercise and 2 to 2 to 3 minutes after exercise ended. T tower wave continued for 2 to 6 (average 3.8) min. Elevated T wave appeared in V2, V3 lead in 11 cases (91.7%), V4 lead in 9 cases (75%), inferior wall II, III, aVF lead in 3 cases, V1 lead in 1 case. T wave amplitude V2 lead 1.0 ~ 2.3 (average 1.55) mV, V3 lead 0.5 ~ 2.0 (average 1.52) mV, V4 lead 0.8 ~ 1.6 (average 1.0) mV, lower wall II, III, aVF lead 0.5 ~ 0.9 (average 0.7) mV, angina pectoris occurred in 9 cases, 1 case of T wave wave 2min when the sudden onset of ventricular fibrillation, cardioversion by electric shock. Analysis of 12 cases of coronary angiography, anterior descending branch disease in 8 cases (66.7%), anterior descending artery plus right coronary artery lesions in 2 cases, right coronary artery and three lesions in 1 case. PTCA surgery in 10 cases, stent implantation in 8 cases. Conclusions Treadmill exercise test induced a huge rise in T wave is a reliable positive standard for judging coronary artery disease.