运动试验后收缩压的异常恢复对冠心病的诊断价值  

The value of abnormality of post-exercise systolic blood pressure in the diagnosis of coronary ar-tery disease

作　　者：邵阳贞[1] 李勋[1] 张代民[1] 王国强[1] 宋建平[1] 杨向军[1] 蒋文平[1] 

机构地区：[1]苏州大学附属第一医院心内科,215006

出　　处：《中国医师进修杂志（内科版）》2007年第7期6-8,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的评价运动试验后收缩压的异常恢复对冠心病的诊断价值。方法将110例先后行平板运动试验和选择性冠状动脉造影（CAG）检查的胸闷、胸痛患者，根据CAG结果分为CAG阴性组和CAG阳性组。CAG阳性组根据冠状动脉病变支数分为三支、两支、单支病变亚组。采用运动后收缩压的异常恢复为运动试验阳性判定标准，即运动后3min时收缩压与运动后1min时收缩压的比值（ratio）≥0．95。结果ratio诊断冠心病的灵敏度为76．27％，特异度为82．35％，准确度为79．09％，阳性预测值为83．33％，均高于ST段压低标准；且ratio值与冠状动脉病变支数呈正相关（r=0．916，P〈0．01）。结论运动试验后收缩压的异常恢复可作为诊断冠心病的有效指标。Objective To evaluate the diagnostic value of the abnormal recovery of post-exer-cise testing systolic blood pressure （PSBP） for detecting coronary artery disease （CAD）. Methods Treadmill exercise testing was conducted in 110 patients with chest distress and chest pain, each of whom underwent selective coronary angiography and was categorized into negative and positive group with the lat-ter further grouped into three vessels group, two vessels group and single vessel group according to the re-sults of coronary angiography. The variable adopted to assess the recovery of blood pressure after exercise was abnormal recovery of PSBP, defined as the state when the ratio of PSBP at the third minute/the first minute≥0.95. Results Abnormal PSBP recovery had higher sensitivity （76.27%）, specificity （82.35 % ）, accuracy （79.09%）, positive predictive value （83.33%） than those of ST-segment de-pression for detecting CAD in patients with angina pectoris. And the ratio value increased with the number of diseased coronary arteries （ r= 0.916, P 〈 0.01 ）. Conclusion Abnormal ratio of PSBP may be an effective index for diagnosing CAD.

关 键 词：运动试验 收缩压 冠状动脉 心绞痛 

分 类 号：R541.4[医药卫生—心血管疾病]