心电图运动试验对急性心肌梗塞后患者残余心肌缺血的评价  

EXERCISE ECG TESTING FOR THE EVALUATION OF MYOCARDIAL ISCHEMIA AFTER ACUTE MYOCARDIAL INFARCTION

作　　者：吴林[1] 张钧华[1] 何晓蕴[1] 朱国英[1] 杨虎[1] 童琳[1] 邵耕[1] 

机构地区：[1]北京医科大学第一医院心内科

出　　处：《中国循环杂志》1994年第7期387-390,共4页Chinese Circulation Journal

摘　　要：５２例急性心肌梗塞后２～１２周患者进行次极量蹬车心电图运动试验，心肌缺血发生率为４４．２％。与冠状动脉造影对比，多支病变者阳性率高于单支病变（Ｐ＜０．０１）；与运动２０１铊心肌显像对比，前者阳性率较低（Ｐ＜０．０１）；心电图运动试验中非梗塞区心肌缺血组阳性率高于梗塞周围缺血组（Ｐ＜０．０２５）；ＳＴ段抬高组左室射血分数低于ＳＴ段正常或压低组（Ｐ＜０．０１）。心电图运动试验对诊断梗塞后残余心肌缺血，特别是非梗塞区心肌缺血有一定价值，运动中ＳＴ段抬高可能预示较差的心功能。Fifty-two patients who had acute myocardial infarction 2-12 weeks ago were studied by exercise ECG test. 44. 2% of the patienes showed myocardial ischemia. There was no significant difference between patients with and without postinfarction angina (52% and 36%, respectively, p>0. 2), The occurrence rate of myocardial ischemia was significantly higher in patients with multivessel disease in coronary angiography than those with single-vessel disease (64% and 18%,respectively , p<0. 01). 22 patients underwent exercise ECG test and exercise thallium-201 scintigraphy simultaneously, the positive rate of the former was lower than that of the latter (31. 8% and 86. 4%, respectively, p<0. 01), but in exercise ECG test, the detection rate of ischemia was higher in patients who had myocardial ischemia in noninfarction area than that in infarction area (80% and 21. 4%, respectively, p<0. 025), LVEF in patients with ST elevation during exercise ECG test was significantly lower than those without. Exercise ECG test can be used to evaluate residual myocardial ischemia after acute myocardial infarction and multivessel coronary disease and predict noninfarction area ischemia. ST elevation may indicate worse LV function.

关 键 词：心肌梗塞 心电图 运动试验 

分 类 号：R542.220.4[医药卫生—心血管疾病]