平板运动试验不同标准诊断冠心病的价值  

The Value of Different Treadmill Exercise Test Criteria for Diagnosing Coronary Artery Disease

作　　者：陈建平[1] 来江涛[1] 郑良荣[1] 陈瑶[1] 

机构地区：[1]浙江大学医学院附属第一医院心内科,310003

出　　处：《心电学杂志》2009年第3期151-153,共3页Journal of Electrocardiology(China)

摘　　要：目的探讨活动平板运动心电图ST段压低、QRS积分和ST／HR指数3种标准诊断冠心病的价值。方法选取可疑冠心病患者共177例，以冠状动脉造影结果为金标准，评价平板运动心电图3种标准诊断冠心病的敏感性和特异性。结果ST段压低、QRS积分和ST／HR指数诊断冠心病的敏感性和特异性均依次增高，ST／HR指数与ST段压低相比敏感性和特异性差异均有显著性意义（P〈0．05），而QRS积分与ST段压低相比仅特异性差异有显著性意义（P〈005）。另外，ST／HR指数随着冠状动脉病变数目的增多而增高，QRS积分随着病变数目的增多而减少。结论①ST／HR指数可提高对冠心病的诊断价值；②当存在干扰性ST段压低时，采用QRS积分是较好的选择；③ST／HR指数、QRS积分可预计冠状动脉病变情况。Objective To assess the value of ST depression, ST / HR index, and QRS score on treadmill exercise electrocardiogram for diagnosing coronary artery disease（CAD）. Methods 177 cases with likelihood of CAD underwent exercise test. The diagnostic sensitivity and specificity of ST depression, ST / HR index, and QRS score were determined based on coronary angiography. Results The sensitivity of ST / HR index and the specificity of both ST / HR index and QRS score were significantly higher than that of ST depression in diagnosis of CAD （ all P 〈 0.05 ）. As the number of diseased coronary arteries increased, the ST / HR index increased and QRS score decreased. Conclusion ST / HR index enhances the diagnostic value of exercise test in CAD. QRS score may be a suitable choice when there are some factors affecting ST segment depression. ST / HR index and QRS score can predict the severity of coronary artery disease.

关 键 词：冠心病 平板运动试验 ST段压低 QRS积分 ST/HR指数 

分 类 号：R541.4[医药卫生—心血管疾病]