运动平板试验诱发ST段改变在老年冠心病患者诊断中的意义  

Significance of treadmill test to induce ST segment changes in elderly patients with coronary heart disease diagnosis

作　　者：李琦[1] 王述兰[1] 王静[1] 

机构地区：[1]兰州大学第一医院,甘肃兰州730030

出　　处：《国外医学（医学地理分册）》2016年第2期134-136,共3页Foreign Medical Sciences：Section of Medgeography

摘　　要：目的探讨运动平板试验中诱发的不同ST段改变在老年冠心病患者诊断中的价值和意义。方法选择2012年3月至2015年3月间就诊于本院的年龄≥60岁的经运动平板试验诊断疑似冠心病患者180例,根据运动平板试验诱发的ST段改变将全部患者分为ST段抬高组、ST段压低组和ST段水平延长组,每组60例。之后采用冠状动脉造影对各组疑似冠心病患者进行确诊。比较各组间冠状动脉造影阳性率、血管病变受累支数比率等。结果经冠脉造影确诊,运动平板试验阳性ST段抬高组中冠心病阳性者49例,ST段压低组阳性52例,ST段延长组阳性54例。各组确诊阳性患者均由不同程度的冠脉狭窄,以单支最为多见,ST段延长组患者单支、双支和三支狭窄数量较ST段抬高组及ST段压低组多,经卡方比较,差异具有统计学意义(P<0.05)。结论在老年患者中,除传统的ST段压低外,ST段抬高和ST段延长提示患者心肌缺血的可能性较大,可作为冠心病诊断和治疗的重要辅助检测指标。Objective To explore the diagnostic significance of ST segment changes induced by treadmill test in elderly patients with coronary heart disease（CHD）.Methods A total of 180 elderly patients with suspected CHD treated during March 2012 and March 2015 were involved.According to the ST segment changes induced by treadmill test,the patients were divided into 3 groups：elevated ST segment group（group A,n=60）,low ST segment group（group B,n=60）,and extended ST segment group（group C,n=60）.Then CHD cases were confirmed with coronary angiography.The positive rate of coronary angiography,and rate of vascular lesions involved were compared among the groups.Results The positive rate of coronary angiography was positive in 49,52 and 54 cases in group A,B,and C.The confirmed CHD cases had different degrees of coronary artery stenosis,mostly single vessels.Group C had more single,double and triple vessel stenosis than the other 2 groups（P0.05）.Conclusion In elderly patients,in addition to the traditional low ST segment,elevation and extension suggest the possibility of myocardial ischemia.Therefore,they can be used as important auxiliary diagnostic indicators for coronary heart disease.

关 键 词：冠心病 运动平板试验 冠脉造影 ST段改变 

分 类 号：R541.4[医药卫生—心血管疾病]