ST/HR斜率对冠心病的诊断价值  

Value of ST/HR slope in detecting coronary artery disease

作　　者：王春晖[1] 李永安[1] 吕波 邓佑黔[2] 

机构地区：[1]重庆医科大学临床学院内科,重庆400016 [2]重庆医科大学临床学院核医学科

出　　处：《临床心血管病杂志》1999年第9期395-397,共3页Journal of Clinical Cardiology

摘　　要：目的：分析 Ｓ Ｔ／ Ｈ Ｒ 斜率对冠心病（ Ｃ Ｈ Ｄ）的诊断价值。方法：应用 Ｓ Ｔ／ Ｈ Ｒ 斜率计算机自动分析系统与运动介入单光子发射型计算机断层摄影术（ Ｓ Ｐ Ｅ Ｃ Ｔ）心肌显像同时进行，检测 ６０ 例临床怀疑 Ｃ Ｈ Ｄ 患者，并对 ３０ 例健康正常人进行了 Ｓ Ｔ／ Ｈ Ｒ 斜率检测。结果：① Ｓ Ｔ／ Ｈ Ｒ 斜率与 Ｓ Ｐ Ｅ Ｃ Ｔ 心肌显像二者结果有良好的相关性（ ｒ＝ ０．５８， Ｐ ＜ ０．００５），符合率为８０％ 。 Ｓ Ｐ Ｅ Ｃ Ｔ 阳性者其斜率值高于 Ｓ Ｐ Ｅ Ｃ Ｔ 阴性者及正常人群（均 Ｐ ＜ ０．０５）。②若以 Ｓ Ｐ Ｅ Ｃ Ｔ 为标准， Ｓ Ｔ／ Ｈ Ｒ 斜率与普通运动试验诊断 Ｃ Ｈ Ｄ 的敏感性分别为８１．６％ 和７３．９％ （ Ｐ ＞ ０．０５），特异性分别为７７．３％ 和４５．５％ （ Ｐ ＜ ０．０５）。以正常人为标准， Ｓ Ｔ／ Ｈ Ｒ 斜率与普通运动试验的特异性分别为９３．３％ 和７０．０％ （ Ｐ ＜ ０．０５）。③ Ｓ Ｐ Ｅ Ｃ Ｔ 显示 ２ 个以上节段心肌缺血者，其斜率值明显高于单一节段缺血者（ Ｐ ＜ ０．０５）。结论： Ｓ Ｔ／ Ｈ Ｒ 斜率对诊断 Ｃ Ｈ Ｄ 有重要价值，其特异性明显高于普通运动试验，可作为评价心肌缺血范围的参考。Objective:To assess the diagnosis values of the ST segment/heart rate (ST/HR) slope in detecting coronary heart disease (CHD).Method:Computer assisted ST/HR slope analysis and exercise stress single photon emission computed tomography (SPECT) myocardial perfusion imaging were conducted at the same time in 60 patients which were suspected to suffer from CHD.Besides 30 normal subjects were examined by ST/HR slope method. Result:①It indicated that the ST/HR slope was significantly correlated with SPECT myocardial imaging(r= 0.58 ,P< 0.005 ), the agreement rate was 80%. ST/HR slope in group with positive SPECT was higher than that in group with negative results and normal subjects (all P< 0.05 ). ②When the SPECT results were used as the criteria for CHD,sensitivity and specificity of ST/HR slope for the detecting of CHD were 81.6 %, 77.3 %,respecitively, those of standard exercise test ECG criteria were 73.9 %, 45.5 %,respecitively (specificity,P< 0.05 Vs ST/HR slope). The specificity of ST/HR slope was higher as compared with standard exercise test ECG criteria ( 93.3 % Vs 70.0 %,P< 0.05 )in normal subjects. ③Moreover,the ST/HR slope in two or more segments ischemia patients was higher than that in single segments (P< 0.05 ).Conclusion:These findings suggest that ST/HR slope is a good method for the diagnosis of CHD and it can detect the extent of myocaridal ischemia in some degree.

关 键 词：冠心病 诊断 ST\HR斜率 SPECT 

分 类 号：R541.404[医药卫生—心血管疾病]