平板运动试验假阳性相关因素的分析  

Evaluation of false-positive factors in treadmill exercise test for coronary artery disease

作　　者：巢为农[1] 吴晶晶[1] 王炳银[1] 李小婷[1] 何振山[1] 刘峰[1] 

机构地区：[1]上海交通大学医学院附属苏州九龙医院心脏中心,215021

出　　处：《临床心电学杂志》2015年第1期27-30,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨活动平板运动试验假阳性相关影响因素,调整观察参数,提高心电图活动平板运动试验评估冠脉病变的价值。方法收集整理2012年1月至2014年6月因疑似冠心病在苏州九龙医院心脏中心接受活动平板运动试验、结果阳性的94例患者,所有患者均在平板运动试验后1w内行冠脉造影检查。根据造影结果将其分为真阳性组(A组)和假阳性组(B组),对比分析两组各项临床资料及活动平板试验数据。结果真阳性组和假阳性组在性别、最大运动耐量(Mets)、运动峰值、心率收缩压乘积方面有显著差异(p<0.05),A组平板运动试验中最大心率与运动终止后2 min心率的差值显著低于B组;A组平板运动试验终止后3 min收缩压与运动终止1 min收缩压的比值、包含2个以上冠心病危险因子的例数明显大于B组(p<0.05)。结论活动平板试验参数结合相关的临床资料、血流动力学相关参数,能提高冠脉病变的诊断准确性,对临床诊断冠心病、评估治疗效果和预后等方面可提供有价值的参考。Objective To evaluate the false-positive related factors of treadmill exercise test for assessing coronary artery disease. Methods Ninety-four patients with positive treadmill exercise test from January 2012 to June2014 in our heart center were recruited in this study. All the patients with suspected coronary heart disease underwent selective coronary angiography within one week after the treadmill exercise test. The patients were divided into two groups： true-positive group（group A） and false-positive group（group B） based on selective coronary angiography results. Comparative analysis of the clinical data and treadmill exercise test data were conducted. Results There were significantly different in sex, the maximum exercise capacity（Mets）, the products of peak exercise heart rate and systolic blood pressure between the true-positive and false-positive groups（p 0.05）. The maximum heart rate and the heart rate of 2 min after the end of the exercise test were significant lower in group A than that in group B（p 0.05）. The ratio of systolic blood pressure 3 min over 1 min after exercise termination was significantly higher in group A than that in group B（p0.05）. Meanwhile there were more risk factors for coronary heart disease in group A than that in group B（p0.05）.Conclusions Treadmill exercise test parameters combined with relevant clinical data, hemodynamic parameters, could improve the diagnostic value and accuracy of coronary artery disease. Meanwhile it could provide valuable reference in assessment of treatment efficacy and prognosis.

关 键 词：平板运动试验 冠脉造影 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]