平板运动试验阳性对冠心病的诊断价值  

Diagnostic value of positive reaction of tread exercise test in coronary heart disease

作　　者：苏琪[1] 吕东月[1] 翟晓燕[1] 曲桂一[1] 王艳龙[2] 高舒航[3] 

机构地区：[1]大连市中心医院心电图室,辽宁大连116033 [2]大连市中心医院外科,辽宁大连116033 [3]大连医科大学,七年制2009级辽宁大连116044

出　　处：《大连医科大学学报》2011年第6期579-582,共4页Journal of Dalian Medical University

摘　　要：[目的]探讨平板运动试验阳性对冠心病的诊断价值。[方法]选取平板运动试验阳性并行冠状动脉造影(CAG)的126例患者临床资料,依据CAG结果将其分成真阳性组和假阳性组,比较两组之间在年龄、性别、冠心病危险因素、ST段偏移的导联数及偏移程度的差异;统计真阳性组患者病变支数在性别上的相关性;分析未达到目标心率患者冠状动脉病变的特点。[结果]①平板运动试验真阳性为59.52%,其中男性为67.5%,女性为40.5%。随着年龄增长,患病的几率增大;病变支数在性别之间差异有显著性意义(P<0.05)。②真、假阳性组在患者年龄、性别及冠心病危险因素之间比较差异有显著性意义(P<0.05)。③ST段损伤性抬高患者真阳性率为100%;ST段下移真阳性主要同时发生肢体和胸前导联且下移>0.2 cm,假阳性主要集中在女性及肢体导联且下移≤0.1～0.2cm,两组之间差异有显著性意义(P<0.05)。④未完成目标心率真阳性患者中,患多支病变较多,其病变狭窄程度较重。[结论]平板运动试验阳性是诊断冠心病的一种理想的非创性筛查方法,运动中应结合患者年龄、性别、冠心病易患危险因素、运动量大小及心电图ST段偏移导联数、程度等因素,才能更好地提高冠心病确诊率。[ Objective] To evaluate the diagnostic value of positive tread exercise test for coronary heart disease. [ Methods ] Multiple clinical data analysis was performed in 126 hospitalized patients with positive tread exercise test and examined by coronary angiography. All the patients were divided into true positive group and false positive group, according to CAG re- suits. Age, gender, the risk factors of coronary heart disease, lead numbers of ST segment deviation and variance of ST seg- ment deviation degree were compared between the two groups. The correlations with number of artery lesions were calculated in gender of true positive group. It was analyzed that characteristics of coronary artery of patients who could not reach the tar- get heart rate in true positive group. [Results] I ） True positive rate of coronary heart disease was 59.52% with male 7.5% and female 40.5%. With aging, the risk of coronary heart disease was increased. The numbers of artery lesions were signifi- cant different statistically between genders （P 〈 0.05 ）. 2） Patients age, gender, risk factors of coronary heart disease were significant difference statistically between the two groups （ P 〈 0.05 ）. 3 ） True positive rate of ST damage of elevation was 100%. True positive ST segment depression always was seen in limb and chest leads and ST segment depression 〉2 cm and false positive was always in female and ST segment depression 0.1 - 2 cm of limb lead. They were significant difference statis- tically （P 〈 0.05）. 4）When target heart rate wasnt completed in true positive patients, the numbers of artery lesions were more and the stenosis of artery was serious. [ Conclusion] Positive tread exercise test was a noninvasive screening method to diagnose coronary heart disease, which can improve diagnostic rate combining with patients age, gender, risk factors of coro- nary heart disease, exercise time, lead numbers of ST segment deviation and ST segment deviation degree.

关 键 词：平板运动试验 心电图 冠脉血管造影术 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病] R46[医药卫生—内科学]