运动试验ST段压低幅度与冠状动脉病变特点的相关性分析

Correlation analysis between the amplitude of st segment depression and the coronary artery lesions in patients with exercise-induced ST depression

目的:了解运动试验ST段压低不同幅度患者的冠状动脉病变和临床特点,并探讨其相关性。方法:选取114例运动试验阳性和可疑阳性同时行冠状动脉造影的患者为研究对象,按ST段压低幅度分为0.5～0.9mm组、1.0～1.9mm组和≥2.0mm组,比较3组患者冠状动脉病变和临床特点。结果:3组患者间的性别、年龄、心绞痛、高血压、糖尿病和室壁运动障碍人数差异无统计学意义(P>0.05),但经皮冠状动脉介入治疗术后的患者人数差异有统计学意义(P=0.032);在冠状动脉病变数目、发生部位方面差异无统计学意义(P>0.05);3组患者间血管狭窄90%以上者差异有统计学意义(P=0.035)。经进一步Logistic回归分析发现,血管狭窄90%以上是ST段压低幅度的独立影响因素。结论:运动试验诱发的ST段压低幅度可间接反映冠状动脉病变狭窄程度,且血管狭窄90%以上是ST段压低幅度的独立影响因素。但ST段压低幅度不能反映冠状动脉病变数目和发生部位。

Objective：To explore the coronary artery lesions and clinical characteristics of the different ST segment depression amplitude in patients with positive or dubitable positive treadmill exercise tests（TET）,and approach the correlation between the amplitude of ST segment depression and the coronary artery lesions.Method：The 114patients with exercise-induced ST segment depression in positive or dubitable positive TET were divided into three groups（0.5-0.9mm,1.0-1.9mm or≥2.0mm group）according to the ST segment depression amplitude.The coronary artery lesions and clinical characteristics of those patients were analyzed.Result：There was no significant statistic difference between the ST depression amplitude and the coronary artery lesions or clinical characteristics except for the patients with post percutaneous coronary intervention（PCI）or the coronary artery stenosis more than 90%.Besides,the coronary artery stenosis was an independent factor for exercise-induced ST segment depression amplitude by Logistic regression analysis.Conclusion：Exercise-induced ST segment depression amplitude probably reflects the pathological degree of coronary artery lesion,and its independent factor was the coronary artery stenosis more than 90%,but hardly reflects the pathological amount or position of coronary artery.