低于亚极运动量的阳性运动试验对冠状动脉粥样硬化性心脏病诊断价值

Diagnostic Value of the Positive Exercise Stress Test of Less than Secondary Exercise Quantity for Coronary Heart Disease

目的了解运动心电图试验的阳性患者中,没有完成亚极运动量者的试验特点及其临床意义。方法分析937例运动平板试验中,94例试验阳性但没有完成亚极运动量者的相关资料。并与56例完成亚极运动量、试验阳性者的冠状动脉造影资料进行对比。结果没完成亚极量的63例男性运动时间(3.68±1.80)min、代谢当量4.98±2.18,其中36例行冠状动脉造影、异常28例(78%)、多支病变8例(22%)、正常8例。完成亚极运动量中的男性46例冠状动脉造影,异常28例(60%)、多支病变4例(8.7%),正常18例。没完成亚极量的31例女性运动时间(2.63±1.59)min、代谢当量3.81±1.79,其中8例行冠状动脉造影的结果和完成亚极运动量的10例女性冠状动脉造影一样、异常率都为50%。结论男性中没有完成亚极运动量的阳性运动试验对冠状动脉粥样硬化性心脏病或冠状动脉病变有较好的诊断价值,如患心绞痛则提示危险分层偏高甚至为不稳定心绞痛,应引起高度关注。此类试验的女性患者诊断价值待定,相关指标和标准有待进一步研究。

Objective To investigate the clinical significance and trail feature of patients without finishing secondary amount of motion among the patients with positive exercise stress test, Methods The data about 94 cases with positive treadmill test while without finishing the secondary exercise were analyzed. Then, this data was compared with the data of coronary arteriongraphy of 56 patients with positive treadmill test and finishing the secondary exercise. Results The exercise time of 63 male patients without finishing secondary amount of motion was 3.68 ± 1.80 min, METs was 4.98 ± 2.18, and among them 36 cases were performed the CAG,the results of CAG are abnormal in 28 cases （78%） ,multivessde diagnosed in 8 cases （22%）, normal in 8 cases. The 46 male patients who finishing secondary amount of motion were performed CAG, abnormal in 28 cases （60%） ,multivessde diagnosed in 4 cases 8.7% ） ,and 18 cases normal, Thirty one female patients without finishing secondary amount of motion was 2.63 ± 1.59 rain, METs was 3.81 ± 1.79, and among them 8 cases were performed the CAG,abnormal in 3 cases （50%） same as 10 females cases who finishing secondary amount of motion. Conclusion The exercise test had better diagnostic value of coronary heart disease or coronary artery disease among males with positive exercise tests while having not finished the secondary amount of motion. Once the angina occurred,it suggested the higher risk staging,even unstable angina,whlch needs more attention. While the diagnostic value of this test in fcmal is not very certain, the related index and standard needs further studying.