平板运动试验最大ST/HR斜率对冠心病的诊断价值  

The Diagnostic Value of the Maximum ST/HR Slope of Treadmill Exercise Test on Coronary Heart Disease

作　　者：丁华民[1] 周玉燕[1] 李俊[1] 耿洪业 祝海城[1] 

机构地区：[1]青岛市市立医院,266011

出　　处：《青岛医药卫生》2000年第4期241-243,共3页Qingdao Medical Journal

摘　　要：目的 探讨最大ST/HR斜率对无症状心肌缺血、有症状心肌缺血、陈旧性心肌梗死病人的诊断价值。方法 应用MAX-1平板运动检测系统,按Bruce方法进行。按照系统内部程序对全部12导联心电图ST/HR斜率自动分析及测定,以Ⅰ、Ⅱ、Ⅲ、avL、avF、V_(4～6)导联中最陡的ST/HR斜率进行分析。结果 最大ST/HR斜率正常人、无症状心肌缺血、有症状心肌缺血、陈旧性心肌梗死分别为0.61±0.11mV·次/min、2.10±0.16mV·次/min、3.01±0.21mV·次/min、3.57±0.19mV·次/min,并且运动强度增加其ST/HR斜率也增加。在运动时间中,达到亚极量心率即刻时最大ST/HR斜率值最高。R波振幅阳性病人其最大ST/HR斜率明显高于阴性病人。结论 平板运动试验最大ST/HR斜率较单纯ST段压低更敏感,不失为一种冠心病诊治中有价值的辅助诊断方法,还可提高运动试验诊断冠心病的准确性。Objective To investigate the diagnostic value of the maximum ST/HR of Treamill exercise test on silent myocardial ischemia,symptomatic myocardial ischemia and remote myocardial infarction. Methods It was finished by using the check-up system of model MAX-1 Treadmill exercise test and Bruce's method. ST/HR slopes of total 12 leads ECG were automatically analysed and measured according to the ordered programme of the system,in which the maximum ST/HR slopes of Lead Ⅰ,Ⅱ,Ⅲ,avL avF and V4-6were adopted. Results The maximum ST/HR slopes in control,silent myocardial ischemia, symptomatic myocardial ischemia,remote myocardial infarction were 0.61±0.11mV time/min,2.10±0.16mV time/min,3.01±0.21mV time/min and 3.57±0.19mV time/min,respectively. The ST/HR slope would increase in pace with the increasement of exercise test intensity.,and reach the maximum at the heart rate of sub-maximum exercise during the test. The maximum ST/HR slopes of patients with positive R-wave amplitude were significantly higher than that with negative R-wave amplitude. Conclusion The maximum ST/HR slope was more sensitive than single ST segment depression. The results indicated that it would be a valuable auxiliary diagnostic method on coronary heart disease,and promote the diagnostic accuracy.

关 键 词：心肌缺血 平板运动试验 最大ST/HR斜率 ST段 

分 类 号：R541.4[医药卫生—心血管疾病]