平板运动试验假阴性冠心病冠状动脉病变特点

Characteristics of coronary lesions in patients with coronary artery disease and false negative results of treadmill exercise test

目的 :了解平板运动试验假阴性的冠心病临床与冠状动脉 (冠脉 )病变特点 ,以提高诊断水平 .方法 :对 12 2例静息心电图正常及平板运动试验阴性而冠脉造影确诊为冠心病患者的临床资料及冠脉造影结果进行分析 .结果 :冠心病危险因素 :高脂血症 86例 (70 .5 % ) ,高血压病 5 6例 (5 0 % ) ,糖尿病 36例 (2 9.5 % ) ,吸烟者 6 9例 (5 6 .6 % ) .冠脉造影显示单支血管病变占 5 7.4 % (70 /12 2 ) ,2～ 3支血管病变占 4 2 .6 %(5 2 /12 2 ) (P <0 .0 5 ) .单支血管病变以前降支者多见 ,占 5 5 .7% (40 /70 ) ,71.4 % (5 0 /70 )单支血管病变狭窄为 5 0 %～74 % .2支血管病变为前降支和右冠者多见 ,占 5 5 .2 % (2 1/38) ;2～ 3支血管病变 5 2例中 4 2例 (80 .8% )血管狭窄部位相互对应 .4 1.2 % (49/12 2 )有侧支循环形成 .结论 :冠心病患者静息及运动心电图正常与单支血管病变者狭窄程度较轻 ,2～ 3支血管病变者血管狭窄部位相互对应及有良好侧支循环形成有关 .

AIM: To study the characteristics of selected coronary artery angiography (SCA) of patients with coronary artery disease (CAD) and false negative results of treadmill exercise test (TET). METHODS: 122 patients with angina pectoris were involved in this study, all of whom had normal resting ECG and false negative results of TET. Their clinical data and SCA of were carefully analyzed. RESULTS: Dangerous factors of CAD among all the 122 patients were as follows: 86 (70.5%) were accompanied with hyperlipidemia, 56 (50%) with hypertension, 36 (29.5%) with diabetes and 69 (56.6%) with smoking history. It was also found that among all the patients, 70(57.4%)were diagnosed with lesions, usually mild stenosis, in single vessel (55.7% in LAD), and 52 (42.6%) with lesions in more than one vessel (55.2% in LAD and RCA). Among these 52 patients, 42 (80.8%) were found to have lesions at corresponding locations of the more than one vessel. Collateral circulations were found in 49 of the 122 patients (41.2%). CONCLUSION: Normal resting ECG and false negative results of TET in patients with CAD are related to mild stenosis of single vessel, corresponding locations of lesions of more than one vessel and the formation of collateral circulations.