运动试验R波振幅改变诊断冠心病临床价值初步探讨(附170例冠状动脉造影对照)  

CLINICAL EVALUATION OF MULTIPLE LEAD R WAVE CHANGES DURING EXERCISE TEST IN CORONARY HEART DISEASE

作　　者：吴树燕[1] 张家成 杨虎[1] 秦玉萍 李芝仁 童玲[1] 朱国英[1] 邵耕[1] 

机构地区：[1]北京医科大学第一医院心内科

出　　处：《中国循环杂志》1992年第6期537-540,共4页Chinese Circulation Journal

摘　　要：本文报道120例冠心病与50例正常人的次极量卧位踏车运动试验的结果。用运动试验后R波振幅改变的各种参数及传统的ST段改变与冠状动脉造影结果对照。结果表明△R、△RST、ΣR诊断冠心病的敏感性分别为71.7%、75%、68.3%;特异性分别为84%、80%、84%。与ST段指标的敏感性72.5%、特异性76%大致相同。对冠心病的阳性预测值亦相仿。若联合应用各指标,以平行复合试验法计算,运动试验诊断冠心病的敏感性可提高到88.3%;以系列复合试验法计算则特异性可提高到94%。对ST段阴性而R波参数呈阳性者,亦应考虑冠心病的可能。The purpose of this study is to evaluate the diagnostic value of multiple lead R wave changes during exercise test in coronary heart disease (CHD). 120 cases of CHD diagnosed by coronary angiography and 50 normal individuals were studied. The results showed that the sensitivity and specificity of △R, △RST, ΣR were 71.7%, 75% and 68.3%;84%,80% and 84%,respectively. These results were compatible with ST segment changes with a sensitivity of 72.5% and specificity of 76%. Their predictive values are also compatible. As multiple parameters were used, the sensitivity of exercise ECG test in the diagnosis of CHD could be raised to 88.3% by using parallel composite calculation and the specificity could be raised to 94% by using serial composite calculation. Our study suggests that in cases with negative ST segment changes but positive R wave changes in exercise ECG test the diagnosis of CHD should be considered.

关 键 词：运动试验 R波振幅 冠心病 

分 类 号：R541.404[医药卫生—心血管疾病]