胸痛患者心电图平板运动试验阳性结果分析

Study of positive results of electrocardiogram treadmill exercise test for patients with chest pain

目的 正确分析心电图运动试验 (TET)阳性结果 ,提高诊断水平。方法 对 2 5 8例胸痛患者进行TET和冠状动脉造影 (CAG)检查 ,收集病史及各项检查资料。 (1)对比分析TET真阳性组和假阳性组的临床资料特点 ;(2 )对比分析女性患者TET真阳性组和假阳性组的临床资料特点。结果 (1)TET假阳性组女性患者例数较多 ;具有典型胸痛症状、高脂血症、吸烟史、冠心病家族史的例数较少 ;运动中ST段的下降多发生于Ⅱ、Ⅲ、aVF导联 ,ST段下降 >0 2mV以及运动中出现心绞痛的例数较少 ;(2 )女性患者TET假阳性组 <6 0岁、静息心电图ST段改变及左室肥厚的例数多于真阳性组 ,差别有统计学意义。结论 应结合性别、典型缺血性胸痛症状、冠心病的某些危险因素、左室肥厚、运动前后心电图变化的部位和程度。

Objective To correctly analyze the positive results of electrocardiogram treadmill exercise test (TET) and improve the level of diagnosis of CHD Methods Two hundred and fifty eight patients with chest pain underwent TET and CAG; the case history and different clinical parameters were collected (1) Clinical data of the true positive group and the pseudo positive group were compared and underwent a statistic analysis (2) Clinical data of the female positive group were compared and underwent a statistic analysis Results The number of females in the pseudo positive group was larger than in the true positive group;The number of patients with typical chest pain, hyperlipidemic history, history of smoking, family history of CHD was smaller than in the true positive group;In the pseudo positive group,the changes of ST segment were mainly in Ⅱ, Ⅲ and aVF The number of extent of changes of more than 0 2 mV and with angina induced during exertion in pseudo positive group was smaller than in true positive group In females, under 60 years, the number of ST segment changes of resting ECG and left ventricular hypertrophy was larger in pseudo positive group than in true positive group The difference was significant Conclusion The factors including sex, typical chest pain,risk factors of CHD, the location and extent of ECG changes and angina induced following exertion should be combined to analyze the positive results of TET