微伏级T波电交替及ST/HR指数对冠心病的诊断价值

Diagnostic value of microvolt T-wave alternants and ST/HR index in coronary heart disease

目的研究平板运动试验(TET)阳性患者的临床资料及TET各参数。方法 245例TET阳性患者经冠状动脉造影(CAG)检查分为冠心病(CHD)组和非CHD组,收集临床资料,对两组患者的临床资料及TET各参数进行分析研究。结果和非CHD组比较,CHD组男性、年龄增大、高血压、糖尿病、吸烟、CHD家族史、基础收缩压、峰值心率、运动最大心率与预计最大心率比值(r HR)、心率储备使用率(HRR)、微伏级T波电交替(MTWA)及ST/HR指数均是CHD的危险因素(P<0.05);Logistic回归分析显示,男性、糖尿病、CHD家族史、HRR及MTWA是CHD的危险因素;ROC曲线下面积分析:MTWA(AUC:0.578,P=0.038)和ST/HR指数(AUC:0.669,P=0.034)是较好的预测指标。结论男性、糖尿病、CHD家族史、HRR及MTWA是CHD的危险因素;MTWA及ST/HR指数可提高TET诊断CHD的准确性。

Objective To investigate the prognostic value of microvolt T-wave alternants and ST/HR index in patients with positive result in treadmill exercise test （TET）. Methods A total of 245 patients with positive result in TET were included in the study, and they were divided into coronary heart disease （CHD） group and non CHD group based on coronary angiography. Results Gender, age, hypertension, diabetes, smoking, family history of CHD, basic systolic pressure, the maximum heart rate, the ratio of the maximum heart rate over expected maximum heart rate （rHR）, heart rate reserve （HRR）, microvolt T-wave alternants （MTWA）, and ST/HR index were risk factors for CHD （P 〈 0.05）. Logistic regression analysis indicated that male, diabetes, family history of CHD, HRR, and MTWA were independent risk factors for CHD. Area under the curve （AUC） analysis suggested that MTWA （AUC： 0.578, P = 0.038） and ST/HR index （AUC： 0.669, P = 0.034） were promising diagnostic biomarker for CHD. Conclusion MTWA and ST/HR index can inprove the accuracy of TET in diagnosing CHD.