平板运动试验Duke评分对冠心病危险分层  

The Evaluation of Duke Treadmill Score in the Risk Stratification of Coronary Heart Disease Patients

作　　者：沈毅[1] 沈爱东[1] 顾复生[1] 沈潞华[1] 郑平渝[1] 李莉[1] 李虹伟[1] 贾三庆[1] 吴生梅 王丽波 

机构地区：[1]首都医科大学附属北京友谊医院心内科,北京市100050 [2]新疆哈密石油医院功能科 [3]内蒙古赤峰市元宝山区医院内科

出　　处：《中国循环杂志》2008年第3期182-185,共4页Chinese Circulation Journal

摘　　要：目的:评价平板运动试验Duke评分(DTS)对冠心病危险分层的实用性。方法:选择151例胸痛患者行心电图平板运动试验(ETT)和冠状动脉造影检查,按DTS分为DTS中危组(DTS-10～+4,n=65)和DTS高危组(DTS≤-11,n=86),将其结果进行对照分析。用交叉表卡方检验的方法分析Duke评分预测有意义(至少1支≥50狭窄)和重度(3支或左主干)冠状动脉病变的价值。结果:在DTS高危组中ST段偏移、ST/HR-index、限制性心绞痛例数和年平均病死率均明显高于DTS中危组;而无心绞痛例数、运动时间和运动负荷量明显低于DTS中危组(P均<0.001),差异均有统计学意义。随冠状动脉病变严重程度的加重DTS高危组病例数显著增多,冠状动脉造影阳性有意义病变(至少1支≥50狭窄)者DTS中危组44例(67.7),DTS高危组80例(93.0);重度病变(3支或左主干狭窄)DTS中危组9例(13.8),DTS高危组39例(45.3)。年平均病死率DTS中危组为(2.9±1.1)、DTS高危组为(6.8±1.6),两组相比差异均有统计学意义(P均<0.001)。结论:DTS不仅提供准确的预后数据,而且能预测冠状动脉病变程度,应用该评分可以更好的进行冠心病危险评估。Objective：To evaluate the efficacy of the Duke treadmill score （DTS）for risk-stratification of significant or severe coronary heart diease. Methods ：One hundred and fifiy-one patients with chest pain undergoing electrocardiogram treadmill exercise test（ETF） and coronary angiography were enrolled, and those who were divided moderate-risk DTS group（ score-10 - ＋ 4, a = 65 ）and high-risk DTS group （score ≤ - 11, n = 86 ）. The clinical data, ETF data and coronary angiograpby results were compared between two groups. Crosstabs Chi-Square Test was conducted to predict signitycant（ least 1-vessel ≥50% stenosis）and sever（ 3-vessel or left main） coronary heart disease. Results：In high-risk group had more ST deviation, higher ST/HR-index, more exercise-limiting angina patients and average annual mortality;but less non-angina, less exercise time, lower workload than the moderate-risk group（ all P 〈 0. 001 ）. Along with the extent of coronary artery disease was gravity, the high-risk group patients were increased. Positive coronary angiography significant（ least 1-vessel 〉/50% stenosis ）patients 44 （67.7%）and 80 （93.0%）, sever（ 3-vessel or left main）coronary artery disease patients 9 （ 13.8% ）and thirtieth-nine patients （45.3 % ）for moderate-and high-risk DTS groups respectively （all P 〈 0. 001 ）. Predicted average annual mortality was 2.9% and 6. 8% for moderate-and high-risk DTS groups respectively（P 〈0. 001 ）. Conclusions ： The composite DTS not only provides accurate prognostic estimation but also predicts the extent of coronary artery disease. Utilizing DTS can help to improve the risk evaluation of coronary heart disease.

关 键 词：运动试验 DUKE评分 冠状动脉造影 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病]