平板运动试验阳性而冠脉造影正常的胸痛患者72例分析

Clinical analysis in 72 patients with chest pain and abnormal treadmill exercise test but normal coronary angiography

目的:分析平板运动试验(TET)阳性而冠脉造影(CAG)正常的胸痛患者的临床特征,增强对TET假阳性及其临床意义的认识,提高冠心病(CAD)的诊断准确率。方法:对我科近3年因胸痛住院行TET检查结果阳性而CAG正常的72例患者的临床特征进行回顾性分析。结果:TET阳性而CAG阴性的患者以女性多见(61.1%),心绞痛症状多不典型(63.9%),心脏彩超检查可以正常(57.1%)。结论:TET阳性且有典型心绞痛症状,但冠脉造影正常的高血压患者,其发病机制应考虑为冠脉微血管病变所致;而心绞痛症状不典型者、或仅以心律失常为表现者、女性患者,若不伴或极少伴有CAD危险因素,临床诊断CAD更应慎重。

Objective： To analysis the data of patients with chest pain and abnormal treadmill exercise test but normal coronary angiography, and enhance our understanding of TET false-positive. Methods： Retrospective analysis the clinical characters of 72 patients with chest pain and abnormal treadmill exercise test without coronary stenosis. Results： Abnormal treadmill exercise test but normal coronary angiography had more prevalence in female （61.1 %）, but their angina pectoris symptom was not typical （63.9 %）, heart color Doppler examine was normal （57. 1 %）. Conclusion： The clinical diagnosis of CAD should be careful for hypertension patients with not typical angina pectoris, or only with arrhythmia, or female, have no or have very few CHD risk factor