平板运动试验Duke评分在冠心病中的应用研究  

Application research of Duke treadmill score on treadmill exercise test in coronary heart disease

作　　者：张莉 李想 高文辉 冀永红 马瑞琴 

机构地区：[1]宁夏医科大学总医院心脏中心功能检查部心电图室,宁夏银川750004 [2]宁夏医科大学总医院医学实验中心,宁夏银川750004

出　　处：《宁夏医学杂志》2017年第10期888-890,共3页Ningxia Medical Journal

基　　金：宁夏科技支撑计划项目(201526)

摘　　要：目的探讨平板运动试验Duke评分(DTS)在冠心病中的应用价值,通过Duke评分对冠心病严重程度进行评估。方法选择200例胸痛患者行心电图平板运动试验(ETT)和冠状动脉造影检查。按DTS分为低危组(DTS≥+5,n=38)、中危组(DTS-10+4,n=94)、高危组(DTS≤-11,n=68),将3组患者的ETT参数以及冠状动脉造影结果进行比较。结果在DTS高危组和中危组中运动时心绞痛发作分别为45例、38例,ST段偏移值分别为(-2.58±1.2)mm、(-1.51±1.0)mm,均明显高于DTS低危组(P<0.05);而Duke评分值[(-12.9±2.0)分、(-1.7±4.2)分]、运动负荷量[(5.5±1.6)、(6.8±1.6)]、运动时间[(3.6±1.5)、(4.9±1.4)min]明显低于DTS低危组(P<0.05)。Duke评分高危组冠状动脉造影阳性64例(94.1%),明显大于中危组、低危组,3组患者两两相比差异均有统计学意义(P<0.05)。结论平板运动试验Duke评分能够为冠病患者提供诊断及预后数据,运用该评分可以对冠心病进行危险评估及预后的判断。Objective To explore the value of treadmill test Duke score on diagnosis of coronary heart disease （CHD） and to assess severity of CHD by Duke Treadmill Score. Methods A total of 200 patients with chest pain undergoing electrocardiogram tread- mill exercise test （ETT） and coronary angiography were enrolled. According to the DTS value ,patients were divided into three groups： low - risk DTS group（ DTS ≥＋ 5, n = 38 ）, moderate - risk DTS group （ DTS：-10 to ＋ 4, n = 94）, and high - risk DTS group （ DTS≤-11, n = 68）. The ETr data and DTS were compared with the coronal artery angiography results in three groups. Crosstabs Chi - Square Test was conducted to analyse the correlation between them. Results In high - risk group and moderate - risk DTS group, there were more exercising angina case （45 cases,38 cases） and more ST - segment deviation （ - 2.58±1.2, - 1.51±1.0） mm than the low - risk DTS group（ P 〈 0.05 ）, but DTS（ - 12.9 ± 2.0, - 1.7 ± 4.2 ）, less exercise time （ 3.6±1.5,4.9±1.4） rain and lower work - load （5.5 ±1.6,6.8 ±1.6）compared with those in low- risk DTS group（ P 〈 0.05 ）. Positive coronary angiography patients were 64 （ 94.1% ） in high - risk DTS group ,which were higher than the moderate - risk group and low - risk DTS group（ P 〈 0.05 ）. Patients with high - risk DTS had sever coronary artery disease. Conclusion DTS can provide diagnostic and prognostic data for CHD patients and is useful for the risk evaluation of coronary artery disease.

关 键 词：平板运动试验 DUKE评分 冠心病 冠状动脉造影 

分 类 号：R540.41[医药卫生—心血管疾病] R541.4[医药卫生—内科学]