平板运动试验恢复期心电图ST段下降对冠状动脉病变程度的预测价值  

The predictive value of ST segment depression on electrocardiogram(ECG) for coronary artery lesion severity during recovery period of treadmill exercise test

作　　者：郜玲[1] 王晋丽[1] 马一鸣[1] 郭艳[1] 石亚君[1] 陈韵岱[1] 

机构地区：[1]解放军总医院心脏无创检测中心,北京100853

出　　处：《中华保健医学杂志》2015年第1期14-16,共3页Chinese Journal of Health Care and Medicine

基　　金：国家科技支撑计划(2013BAI17B06)

摘　　要：目的探讨平板运动试验出现运动中心电图上斜型ST段下降及运动后合并ST段水平或下斜型下降与冠状动脉狭窄程度的关系。方法从2013年-2014年行平板运动试验检查的患者2095例患者中,选取99例平板运动试验出现运动中心电图上斜型ST段下降〉0.10 m V并行冠状动脉造影检查（CAG）的患者,根据CAG中病变最严重血管的狭窄程度结果分为4组：A组（无狭窄）12例,B组（0-50%）15例,C组（51%-75%）23例,D组（76%-100%）49例。对4组患者一般情况、平板运动试验前中后各项指标、静息心率、最大目标百分比、运动时间、METS值、运动时心电图ST段下降最大值、运动时ST段下降持续时间、运动后是否合并ST段下降、平板运动试验结果等进行分析。结果 4组患者一般情况、静息心律、最大目标百分比、运动时间、运动耐量（METs）比较,差异无统计学意义（P〉0.05）,均衡性较好;4组患者心电图上斜性ST段持续时间比较,差异有统计学意义（P〈0.01）,恢复期合并ST段下降与冠状动脉狭窄程度具有相关性（P=0.014,spearman等级相关系数为0.3141）。运动后出现心电图ST段下降多为水平型或下斜型（89.6%）。结论平板运动试验恢复期心电图ST段下降与冠状动脉狭窄程度有相关性,可作为判别冠状动脉狭窄程度的辅助指标。Objective To comprehensively examine the association of ST segment depression on electrocardiogram（ECG）during and after treadmill exercise test. Methods Ninety-nine subjects with ST segment oblique depression during TET were enrolled in this study from 2013-2014. They were divided into four groups by the stenosis degree of artery using coronary arteriography（CAG） results：no stenosis（n = 12）,stenosis of 0 - 50%（n = 15）,stenosis of 51 - 75% and stenosis of 51 - 75%（n =49）. General condition of patients and related indicators were observed before and after treadmill exercise test. Results There was no significant difference in general condtion,heart rate,maximum target percentage,exercise time,or METs between the four groups.There were significant differences in the duration of the ST segment oblique depression. The appearance of ST segment depression during recovery period was associated with the degree of coronary artery stenosis（P = 0.014）. Conclusion The appearance of ST segment during recovery period can be used as an index of the severity of coronary artery stenosis.

关 键 词：冠心病 平板运动试验 恢复期 ST段下降 

分 类 号：R541.4[医药卫生—心血管疾病]