活动平板试验对心肌缺血的检测分析

ANALYSIS OF MYOCARDIAL ISCHEMIA DURING EXERCISE TESTING

对冠状动脉造影确诊的５０例冠心病患者，以心电图活动平板运动试验进行检测。划分无痛（２９例）与有痛（２１例）两组分析，发现运动诱发心绞痛与诊断性ＳＴ段改变相结合方法，可提高确诊率（７２％），并多见于冠状动脉多支病变。运动无痛、无诊断性ＳＴ段改变者（假阴性）绝大部分为单支病变。本结果提示，除ＳＴ段改变外，最大心率、运动持续时间及心率─血压双乘积，亦有助于心肌缺血的临床判断。

Silent and symptomatic myocardial ischemias induced by exercise were studied in 50 patients with coronary heart disease proved by coronary arteriogram. They were divided into 2 groups, one group(n=21) with exercise-induced angina pectoris and the other(n=29) with exercise-induced silent myocardial ischemia. The diagnostic accuracy could be raised(72%) by the presence of exercise-induced angina pectoris and ST-segment depression≥1mm. Most of the patients with symptomatic myocardial ischemia and ST-segment depression had multivessel disease;while most of those with false negative exercise test(silent myocardial ischemia with no diagnostic ST-segment changes) had single vessel disease. The overall results suggests that peak heart rate, exercise duration, the product of peak heart rate and blood pressure together with ST-segment depression are helpful to the clinical diagnosis of myocardial ischemia.