平板运动试验中单纯恢复期ST段压低对冠心病的诊断价值及其临床特点  

Diagnostic value and clinical feature of ST-segment depression limited to the recovery phase of treadmill exercise test

作　　者：王岚[1] 黄煦航 郭丹杰[1] 郭琳[1] 曹文颖[1] 文汝新 张文争[1] 杨军[1] 

机构地区：[1]北京大学人民医院心脏中心心内科,100044

出　　处：《中华临床医师杂志（电子版）》2015年第22期1-5,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的 探讨平板运动试验中单纯恢复期ST 段压低对冠心病的诊断价值及其临床特点.方法 回顾性入选176 例平板运动试验阳性的患者,根据其ST 段压低出现时间将其分为运动期ST 段压低组（n=140）和恢复期ST 段压低组（n=36）,比较其临床资料及冠状动脉造影结果.结果 两组患者-般临床特点（如性别、年龄）无差异.恢复期ST 段压低组的冠状动脉造影阳性率与运动期ST 段压低组无统计学差异（55.7% vs. 61.1%,P=0.348）.但恢复期ST 段压低组前降支累及率更高（100% vs. 83.3%,P=0.031）.与运动期ST 段压低患者相比,恢复期ST 段压低患者峰值SBP 水平更高[（165±23）mmHg vs.（177±17）mmHg,P=0.010],提前终止试验的比例更低（31.4%vs. 11.1%,P=0.003）,运动时间更短[（416±146）s vs.（337±144）s,P=0.003]以及ST 段压低持续时间更短[462（120～1 114）s vs. 294（120～831）s,P=0.029].结论 诊断冠心病方面,平板运动试验中单纯恢复期ST 段压低与运动期出现的ST 段压低具有同等重要的价值.恢复期ST 段压低患者中前降支病变的比例更高.而恢复期ST 段压低患者的年龄、性别与运动期ST 段压低的患者无差别.Objective To investigate the diagnostic value and clinical feature of ST-segment depression limited to the recovery phase of a treadmill exercise test, as compared with that of ST-segment depression appearing during exercise. Methods Clinical and angiographic data was compared for 140 consecutive patients who developed ST-segment depression during the exercise phase of an exercise test (exercise group) and for 36 patients who developed ST-segment depression limited to the recovery phase of the exercise test (recovery group). Results There were no differences between the 2 groups in major clinical feature. Significant coronary artery stenosis were found in 78 exercise group patients (55.7%) and in 22 recovery group patients (61.1%, P=0.348). However the involvement rate of LAD was higher in recovery group (100%) than that in exercise group (83.3%, P=0.031). As to treadmill exercise test, compared with exercise group, recovery group patients showed higher peak SBP level (165±23 mmHg vs. 177±17 mmHg, P=0.010), lower rate of premature termination (31.4% vs. 11.1%, P=0.003), shorter duration of exercise [(416±146)s vs. (337±144)s, P=0.003] and shorter duration of ST-segment depression [462 (120-1 114) s vs. 294 (120-831) s, P=0.029]. Conclusion The diagnostic power of ST-segment depression limited to the recovery phase of an exercise test is equal to that of ST-segment depression induced during effort. Involvement rate of LAD was seem to be higher in recovery group than that in exercise group. And the gender and age feathers between 2 groups are similar.

关 键 词：运动试验 冠心病 诊断 

分 类 号：R541.4[医药卫生—心血管疾病]