应用心率的恢复诊断PCI术后再狭窄  

The value of heart rate recovery after treadmill exercise test in diagnosis of restenosis in patients with percutaneous coronary intervention

作　　者：欧阳清彦[1] 涂爱兰[1] 邹月娥[1] 梁健球[1] 

机构地区：[1]广东省佛山市第二人民医院,528000

出　　处：《临床心电学杂志》2012年第2期123-125,111,共4页Journal of Clinical Electrocardiology

摘　　要：目的评价平板运动试验后心率恢复在PCI术后再狭窄诊断中的价值。方法成功行经皮冠状动脉介入治疗(PCI)的88例患者,术后6～9个月行平板运动试验及冠状动脉造影,以冠状动脉造影结果为参照,比较传统标准结合心率恢复异常与传统标准诊断再狭窄的敏感性、特异性、阳性预测值、阴性预测值。结果 88例患者中有22例经冠状动脉造影证实发生再狭窄。与传统标准相比,以运动后第一分钟心率恢复值(HRR1))异常诊断再狭窄的敏感性、特异性、阳性预测值和阴性预测值无明显差异(p>0.05)。在传统标准阳性的基础上结合HRR1异常诊断再狭窄的特异性(86.4%)较传统标准有显著提高(p<0.05)。结论运动后心率恢复异常可作为诊断再狭窄的无创方法之一,传统标准结合HRR1异常可提高平板运动试验对再狭窄的诊断价值。Objective To evaluate the value of heart rate recovery after treadmill exercise test （TET） in di- agnosis of restenosis in patients with percutaneous coronary intervention （PCI）. Methods Eighty-eight patients who had undergone PCI successfully for 6-9 months were involved, all patients had TET and coronary angiogra- phy（CAG）, the sensitivity, specificity, positive predictive value and negative predictive value of traditional stan- dards Combined with abnormal heart rate recovery at l min after exercise termination （HRR1） were compared with traditional standards in diagnosis of restenosis using coronary angiography as gold standard. Results in 88 cases, the positive of CAG was 22 cases. There was no significant differences in the sensitivity, specificity, posi- tive predictive value and negative predictive value between the traditional standards and HRR1 in diagnosis of restenosis（p〉0.05）. However, the specificity of abnormal HRR1 markedly elevated base on the positive outcomes of the traditional standards, being 86.4% （p 〈0.05）. Conclusion Abnormal heart rate recovery after treadmill ex- ercise test can be used to diagnose restenosis after PCI, traditional standards Combined with abnormal HRRl can enhance the value of TET in diagnosis of restenosis.

关 键 词：经皮冠状动脉介入治疗 平板运动试验 心率恢复 冠状血管造影术 再狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]