目的：分析心肌缺血患者立体心电向量图各个参数的特点。方法门诊及住院胸痛患者139例，均进行运动平板试验，按其结果分别将研究对象分为3组：心肌缺血组（平板试验结果阳性患者）、可疑心肌缺血组（平板试验结果可疑阳性患者）和对照组（平板试验结果阴性患者），同时采集立体心电向量图数据。结果心肌缺血组比对照组的空间QRS-T夹角[（64±44）°比（25±20）°，P＜0．05]和空间QRS-T比值[（96．3±3．4）比（4．2±2．4），P＜0．05]明显增大；心肌缺血组比对照组的ST时间、T环的最大向量仰角和水平角增大，T环长、宽、面积及最大向量振幅减小，差异均有统计学意义。结论立体心电向量图可以检出胸痛患者心肌缺血心电异常，复极方向、大小有显著改变，且除极和复极方向、大小差异变大。%Objective To analyze the characteristics of the various parameters of three-dimensional electrocar-diogram (ECG) in patients with myocardial ischemia. Methods We enrolled 139 patients with chest pain from the out-and in-patient departments. Patients were based on the findings of exercise treadmill tests, assigned to myocardial ischemia group (positive findings), suspected myocardial ischemia group (suspected positive findings) and control group (negative findings), which entailed the analyses on the three-dimensional ECG data. Results Compared with control group, the myocardial ischemia group was characterized by enlarged spatial QRS-T angle [(64 ±44)° vs. (25 ± 20)°, P<0.05] and the spatial QRS-T ratio (6.3±3.4 vs. 4.2±2.4, P<0.05). Compared with control group, the myocardial ischemia group yielded a lengthened duration of the S-T segment, enlarged elevation and horizontal angle of the maxi-mal vector of T loop, as well as minimized length, width and area of T loop and the maximal vector amplitude (all P<0.05). Conclusion In patients with chest pain, three-dimensional ECG can detect abnormalities of myocardial is-chemia, which are characterized by the changes in the direction and amplitudes of depolarization and repolarization.
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