运动心电图与PCI术后心肌缺血部位的关系  

The relationship between exercise ECG and myocardial ischemia after PCI

作　　者：汪涛[1] 李琦[1] 韩霞[1] 白明[1] 张钲[1] 

机构地区：[1]兰州大学第一医院,730000

出　　处：《临床心电学杂志》2010年第6期416-418,共3页Journal of Clinical Electrocardiology

摘　　要：目的以冠状动脉造影(CAG)结果为标准,评价平板运动试验(TET)对冠心病介入治疗(PCI)术后支架内再狭窄及新发病变的定位诊断价值。方法对介入治疗术后6～9个月同时完成TET和CAG的923例患者进行回顾性分析。结果 923例介入治疗术后TET与CAG均阳性144例患者中,①单支病变中,前降支(LAD)与V2～V6导联下移有关,准确度75.3%,与其它导联组比较χ2=154.56,p<0.01;回旋支(LCX)与Ⅱ、Ⅲ、aVF导联下移有关,准确度33.3%,与其它导联组比较χ2=10.92,p>0.05;右冠状动脉(RCA)与Ⅱ、Ⅲ、aVF、V4～V6导联下移有关,准确度60.2%,与其它导联组比较χ2=96.12,p<0.01;②双支病变中(LCX/LAD+LAD/RCA+LCX/RCA)均以Ⅱ、Ⅲ、aVF、V4～V6导联ST段下移为主,准确度47.3%,与其它导联组比较χ2=13.51,p>0.05;③三支病变中涉及的导联包括Ⅰ、Ⅱ、Ⅲ、aVF、V4～V6,其准确度为68.2%,与其它导联组比较χ2=29.31,p<0.01。结论平板运动试验对于评价介入治疗术后支架内再狭窄及新发病变的定位有很高的临床诊断价值。Objective With coronary angiography as the standard,to evaluate the value of treadmill exercise test（TET）. Methods We analyzed 923 cases who had TET and coronary angiography（CAG） during the following 6~9 months after percutaneous coronary interventions（PCI）. Result In 923 cases,positive of TET was 239 cases and negative was 684 cases,the positive of CAG was 198 cases and negative was 725 cases. The accuracy of TET was 83.9%. In the TET positive cases,the accuracy between related ST-segment depression and confirmed by coronary angiography accuracy of single-vessel disease are：LAD 75.3%,RCA 60.2%,LCX 33.3%; in three-vessel disease,ST-depressed in mult-leads Ⅰ、Ⅱ、Ⅲ、aVF、V2~V6.There are few cases in left main disease,we need further discussion. Conclusion TET is very useful to evaluate the restenosis and new lesion after PCI,and with high sensitivity and specificity.

关 键 词：冠脉介入治疗 平板试验运动 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]