ST段压低后恢复时间诊断冠心病的价值

The clinical application of the recovery time after ST segment depression for the diagnosis of coronary heart disease

目的:观察平板运动试验(TET)阳性患者ST段压低后恢复时间在诊断冠心病中的临床意义。方法:回顾性分析我院2014年1月至2015年1月在TET中ST段压低≥0.1 mm的患者133例,根据冠状动脉造影结果显示血管狭窄是否>50%,分为阳性组79例和对照组54例。比较两组患者在TET中ST段压低的导联中最大的压低幅度以及恢复正常的时间。再分析不同病变血管数量的患者ST段压低的最大幅度以及恢复时间。结果:133例TET阳性患者中,79例冠脉造影阳性,总阳性率为59.4%。阳性组ST段恢复时间在>90 s的造影阳性率为76.9%(60/78),并且阳性组最大ST段下移幅度、ST段恢复时间明显要高于对照组,差异有统计学意义(P<0.05)。与单支病变组相比,双支及多支病变组最大ST段下移幅度无统计学意义(P>0.05);双支及三支病变组ST段平均恢复时间明显高于单支病变组,差异有统计学意义(P<0.05)。结论:临床上,平板运动试验阳性的患者结合ST段恢复时间以及ST段压低幅度有利于提高冠心病的诊断,值得临床推广。

Objective To investigate the clinical significance of the ST segment changing in treadmill exercise test positive for the diagnosis of coronary heart disease. Methods 133 patients（hospitalized from January 2014 to January 2015） with the ST segment depression ≥0.1 mm in treadmill exercise test were retrospectively analyzed. Patients were divided into the observation group and the control group according to the coronary angiography（the dividing line is artery stenosis is more than 50% or not）. ST-segment depression margin and recovery time of the two groups were compared. ST-segment depression margin and recovery time of patients with different vascular lesion number were also analyzed. Results In 133 cases, 79 cases of coronary angiography were pos itive（59.4%）. Positive rate of ST segment recovery time（ 〉90 s） was 76.9% in. The maximal ST-segment depression margin and recovery time in the observation group were more than the control group, the difference was statistically significant（P〈0.05）. Compared with the maximal ST segment depression margin in single-vessel stenosis group, the difference in the double-vessel and multi-vessel stenosis group was not statistically significant（P〉0.05）. But in terms of ST-segment recovery time, the double-vessel and multivessel stenosis group were higher than the single-vessel stenosis group, and the difference was statistically significant（P〈0.05）. Conclusion Clinically, patients with TET positive combined the ST segment depression and STsegment recovery time are important hints for the diagnosis of coronary artery disease, and is worthy of promotion.