平板运动试验恢复期与运动中ST段压低在冠心病中的诊断价值比较

The Value of ST-segment Depression During Exercise and Recovery Phase in Diagnosis of Coronary Heart Disease

目的 比较平板运动试验恢复期与运动中ST段压低的心电图表现在冠心病中的诊断价值.方法 选择可疑冠心病患者并行平板运动试验结果呈阳性者211例,将其分成运动中ST段压低组（A组,n=178）,恢复期ST段压低组（B组,n=33）,对两组的临床资料和冠状动脉造影结果进行对比分析.结果两组临床资料（除高尿酸）比较,差异均无统计学意义（均P ＞0.05）.两组对冠状动脉造影的阳性预测值相近（ 71.3%vs72.7%,P ＞0.05）,冠状动脉病变部位及单支、三支病变比较,差异无统计学意义（P ＞0.05）;冠状动脉病变重度狭窄率B组高于A组,差异有统计学意义（P＜0.05）.结论 平板运动试验恢复期ST段压低与运动中ST段压低在冠心病诊断中同样重要,可预示冠状动脉的重度病变.

Objective To evaluate the value of ST-segment depression during exercise or recovery phase in diagnosis of coronary artery disease（CAD）. Methods 211 cases in which CAD was suspected and treadmill exercise test（ TET ）was positive were include. Of them, 178 cases had ST-segment depression during exercise phase （group A） and 33 cases during recovery phase （group B）. Clinical data and angiographic results were analyzed and compared between two groups. Results Clinical data （except hyperuricemia） were significantly different between two groups（P 〈0.05）. A positive coronary angiogram was presented in 71.3% cases of group A and 72.7% cases of group B （P 〉 0.05）. There was no sig- nificant difference of lesion sites, one-vessel and 3-vessel lesions between two groups （P 〉 0.05）. The percent of severe coronary stenosis was significantly greater in group A than in group B （P〈0.05）. Conclusion ST segment depression in the recovery phase is the same importance as that during exercise in diagnosis of CAD and may predict severe coronary artery lesions.