飞行员平板运动试验恢复期ST段压低特点和原因分析

ST-segment depression characteristics and cause analysis of treadmill exercise test recovery phase in pilots

目的探讨平板运动试验恢复期出现ST段压低的特点和原因。方法分析17例飞行员平板运动试验恢复期ST段压低的形态、持续时间以及同导联P波振幅、P-R段和体检鉴定资料,并与同期102例飞行员运动试验阴性者比较。结果恢复期ST段压低者以Ⅱ、Ⅲ、aVF导联多见,占82.4%(14/17);ST段压低在0.10～0.22mV,平均(0.15±0.04)mV,ST段压低以Ⅲ导联最为显著;ST段压低持续时间2～5min,平均(3.6±1.0)min,多在4min内恢复正常,占76.5%(13/17);ST段多呈J点型压低,占82.4%(14/17),其中15例(88.2%)伴P-R段下斜型压低;恢复期ST段压低者,P波振幅在运动终点、运动后3min以及运动后6min均明显高于对照组(P<0.01)。结论运动试验恢复期出现短暂性J点型ST段压低可能与心房复极向量增大有关,应注意结合同导联P波振幅和P-R段形态与病理性ST改变鉴别。

Objective To probe into ST-segment depression characteristics and cause analysis of treadmill exercise test recovery phase.Methods The data of 17 pilots in treadmill exercise test recovery phase were analyzed in terms of ST-segment depression pattern, duration time, lead with P-wave amplitudes,P-R segments,and physical examination information,and compared with 102 pilots with negative exercise tests at the same period.Results ST-segment depression in recovery phase showed more frequently in Ⅱ , Ⅲ, aVF lead accounting for 82.4%（14/17）, ST-segment depression was 0.10-0.22 mV with an average of（0.15±0.04）mV, Ⅲ lead was the most obvious in ST-segment depression.ST-segment depression duration time was 2-5 min with an average of（3.6＋ 1.0）min.Most got right within 4 min accounting for 76.5%（13/17）.ST-segment depression took on J depression accounting for 82.4%（14/17）. 15 pilots （88.2%）had P-R declivity depression.ST-segment depression sufferers in recovery phase,P-wave amplitudes clearly were higher than those of the control group at exercise terminal, 3 min, and 6 rain after exercise（P〈0.01）.Conclusion In treadmill exercise test recovery phase, transient J-point ST-segment depression is probably related to atrial repolarization vector enlargement, so lead with P-wave amplitudes, P-R segment pattern, and pathologic ST changes should be combined together to identify.