平板运动试验对室性早搏危险性的预测

The value of treadmill test in the risk stratification of ventricular premature beats

目的探讨平板运动试验时室性早搏(室早)数和质的变化,以预测室早的危险系数。方法选择24小时动态心电图室性早搏>200次的患者270例,按Bruce方法进行亚极量平板运动试验,并随访2年以上。结果270例患者中64例运动后室早增多呈二联律,25例出现成对室早,于恢复期2、4、6、8min后室早逐渐减少至消失,11例短阵室性心动过速(室速)伴恢复期心电图ST段压低,T波倒置,运动停止后逐渐恢复正常。随访中有5例猝死,其中3例为短阵室速、1例成对多源室早、1例频发室早。结论平板运动预测室性早搏的危险性及诊断各种器质性心脏病或非器质性心脏病引起的功能性早搏有重要的价值。

Objective To evaluate the value of ventricular premature beats (VPB) during treadmill exercise test(TET) by observing the frequency and morphology of VPB. Methods 270 patients with VPB were randomized to perform treadmill test examination according to Bruce proposal, and their frequency and morphology of VPB were recorded. All cases were followed up two years or more. Results The number of VPB increased dramatically and ventricular premature bigeminy occurred in 64 cases, VPB couple occurred in 25 cases. VPB decreased gradually and disappeared during recovery time of 2, 4, 6 and 8 min Paroxysmal ventricular tachycardia occurred in 11 cases followed by temporary ST segment depression and inverted T wave and gradually recovered after stopping. 5 cases died suddenly during following up periods. Among them 3 cases had proxysmal ventricular tachycardia, 1 case had multiple and couple ventricular and 1 case had frequency ventricular premature. Conclusions Treadmill test is helpful to predict VPB risk in patients with structural or non-structural heart diseases.