平板运动试验对冠心病患者经皮冠状动脉介入术后主要心脏不良事件发生的预测价值  

The value of treadmill exercise test in predicting major adverse cardiac events after percutaneous coronary intervention in patients with coronary artery disease

作　　者：徐晓静 王超[1] Xu Xiaojing;Wang Chao(Department of Cardiac Function,the Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People′s Hospital),Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)心功能科,郑州450000

出　　处：《实用医技杂志》2024年第9期617-621,I0001,共6页Journal of Practical Medical Techniques

摘　　要：目的探讨平板运动试验指标对冠心病患者经皮冠状动脉介入(PCI)术后主要心脏不良事件(MACE)发生的预测价值。方法本研究中共纳入116例冠心病患者,所有患者均于河南中医药大学第五临床医学院(郑州人民医院)接受PCI治疗,选取时间为2021年4月至2023年4月,进行回顾性分析,将所有患者根据术后半年是否出现MACE将其分为发生组(30例)和未发生组(86例)。对2组患者基线资料进行统计,所有患者均进行平板运动试验,并对相关指标进行检测。将发生组和未发生组患者基线资料及平板运动试验相关指标进行对比,采用相关性软件分析平板运动试验相关指标和心功能分级、冠状动脉狭窄程度之间的关系,采用多因素分析MACE的高危因素,采用受试者工作特征(ROC)曲线分析平板运动试验的预测价值。结果发生组患者冠状动脉病变支数、Gensini积分、T波峰末间期(Tpe)、微伏级T波电交替(MTWA)及ST/心率(ST/HR)斜率均相较于未发生组升高(均P<0.05),但2组患者性别、体质指数(BMI)、年龄、合并疾病差异无统计学意义(均P>0.05);平板运动试验相关指标和心功能分级、冠状动脉狭窄程度之间均呈正相关关系(均P<0.05);冠心病患者PCI术后发生MACE的高危因素在于心功能分级、冠状动脉狭窄程度、T波峰末间期(Tpe)、MTWA、ST/HR斜率[OR(95%CI)=6.203(3.313,11.614)、6.653(3.623,12.214)、6.153(3.425,11.057)、6.554(3.569,12.032)、7.389(3.810,14.332),均P<0.05);ROC曲线分析结果显示,平板运动试验相关指标联合预测冠心病患者PCI术后发生MACE的灵敏度、特异度分别为89%、86%,高于各项指标单项预测(均P<0.05)。结论将平板运动试验应用于冠心病患者PCI术后发生MACE的预测中,具有较高的临床价值。Objective To evaluate the value of treadmill exercise test in predicting major adverse cardiac events(MACE)after percutaneous coronary intervention(PCI)in patients with coronary artery disease.Methods A total of 116 patients with coronary heart disease were enrolled in this study.All patients underwent PCI at the Fifth Clinical Medical College of Henan University of Traditional Chinese Medicine(Zhengzhou People′s Hospital)from April 2021 to April 2023,all patients were divided into two groups according to the occurrence of MACE(30 cases)and no MACE(86 cases).The baseline data of the two groups were analyzed.All patients underwent treadmill exercise test,and the related indexes were detected.The baseline data and the related indexes of treadmill exercise test were compared between the occurrence group and the non-occurrence group,and the relationship between the related indexes of treadmill exercise test and the grading of cardiac function and the degree of coronary artery stenosis was analyzed by correlation software,the high-risk factors of MACE were analyzed by multi-factor analysis,and the predictive value of treadmill exercise test was analyzed by ROC curve.Results The number of diseased coronary arteries,Gensini score,TPE,MTWA and St/HR slope were significantly higher in patients with CHD than those without CHD(all P<0.05),there was no significant difference between two groups(P>0.05).The correlation analysis software showed that there was a positive correlation between the related indexes of treadmill exercise test and the grading of heart function and the degree of coronary artery stenosis(P<0.05).The high-risk factors of MACE in patients with coronary artery disease after PCI were cardiac function grade,degree of coronary artery stenosis,TPE,Mtwa,St/HR slope[OR(95%CI)=6.203(3.313,11.641),6.653(36.623,12.214),6.153(3.425,11.057),6.554(3.569,12.032),7.389(3.810,14.332),P<0.05].The results of ROC curve analysis showed that the sensitivity and specificity of treadmill exercise test in predicting MACE after

关 键 词：冠心病 运动试验 经皮冠状动脉介入治疗 预测 主要心脏不良事件 

分 类 号：R541.4[医药卫生—心血管疾病]