平板运动试验最大ST/HR斜率对冠心病的诊断价值

Value of maximum ST/HR slope during treadmill exercise test in diagnosing coronary artery disease

目的 探讨平板运动试验最大ST/HR斜率对冠心病的诊断价值。方法 对 10 6例患者进行冠状动脉造影和平板运动试验及 6 0例正常对照者进行平板运动试验 ,测定其最大ST/HR斜率及ST段压低值。结果 冠状动脉造影阳性组最大ST/HR斜率明显高于正常对照组 (分别为 3 8±2 3uV/bp .min和 0 9± 0 4uV/bp .min ,P <0 0 1) ;最大ST/HR斜率法诊断冠心病的敏感性和特异性明显高于ST段压低法 (分别为 95 5 % ,93 6 %和 6 2 5 % ,78% ,均为P <0 0 5 ) ;ST/HR斜率 >6 0uv/bp .min识别三支血管病变的敏感性和特异性较高 (分别为 83 3%和 97 5 % ) ;ST/HR斜率法女性假阳性率明显低于ST段压低法 (分别为 7 1%和 32 1% ,P <0 0 5 )。结论 最大ST/HR斜率对冠心病的临床诊断有较高的敏感性和特异性 ,优于ST段压低法 ,并对预示冠状动脉病变数目有一定的价值。

Objectiv To investigate the value of treadmill exercise test maximal ST segment/heart rate slope (ST/HR slope) in diagnosing coronary artery disease (CAD).Methods The maximal ST/HR slope and ST depression value were measured in 106 persons who underwent both coronary angiography (CAG) and treadmill test and 60 health subjects as controls.Results The maximal ST/HR slope in CAG positive patients was significantly higher than that of control group (3.8±2.3 and 0.9±0.4 uV/bp.min, P <0 01) In diagnosing CAD,both sensitivity and specificity of the ST/HR slope method was significantly higher than that of ST depression criteria (95.5%,93.6% and 62.5%,78%, P <0.05).The sensitivity and the specificity were higher in identifying triple vessel disease when ST/HR slope was more than 6.0uv/bp.min(83.3% and 97.5%).The false-positive was significantly lower by ST/HR slope than by ST depression criteria in women(7.1% and 32.1%, P <0.05).Conclusion The maximal ST/HR slope has higher sensitivity and specificity in diagnosing coronary artery disease.It is better than ST segment depression and it has also predictive value on the number of the diseased arteriosclerostic coronary artery vessels.