平板运动试验中最大ST/HR斜率与ST段压低对冠心病诊断的意义

Significance of the maximal ST/HR slope and ST segment depression during treadmill exercise test in the diagnosis of coronary heart disease

目的 :研究平板运动试验中最大ST/HR斜率与ST段压低对冠心病诊断的临床价值。方法 :选择平板运动试验阳性和冠状动脉造影阳性的患者 5 0例与正常人 5 0例对照 ,研究最大ST/HR斜率的敏感性和特异性。结果 :冠心病患者最大ST/HR斜率 (4 .0± 0 .79μV/bp·min)显著高于对照组 (1.10± 0 .34μV/bp·min) (P<0 .0 1) ,2支以上病变组的最大ST/HR斜率 (6 .2 4± 1.0 7μV/bp·min)显著高于 1支病变组 (2 .10± 0 .5 6 μV/bp·min) (P <0 .0 1)。最大ST/HR斜率诊断冠心病的敏感性和特异性分别是 92 %和 94 % ,准确性为 96 % ,显著高于ST段压低法 (敏感性、特异性和准确性分别为 74 %、72 %和 89% ,均P <0 .0 5 )。结论 :平板运动试验中最大ST/HR斜率法可显著提高冠心病的诊断价值 ,且对冠脉病变支数有一定的定量诊断价值。

Objective:To study the clinical significance of maximal ST/HR slope and ST segment depression during treadmill exercise test (TET) in the diagnosis of coronary heart disease.Methods:Maximal ST/HR slope and ST segment depression value were measured in 50 patients with positive findings of coronary artery angiography (CAG) and TET and in 50 healthy subjects as control. Results: The maximal ST/HR slope in CAG positive group was significantly higher than that of control group (4.0 ± 0.79 and 1.10 ± 0.34 mV/bp×min, P <0.01). In CAG positive group, the maximal ST/HR slope was higher in the group of patients with more than two stenosed arteries (6.24 ± 1.07 mV/bp×min) than that in the group of patients with one stenosed artery (2.10 ± 0.56 mV/bp×min) ( P <0.05). The sensitivity and specificity of the maximal ST/HR slope were 92% and 94%, respectively, which were more significant that those of ST segment depression (74% and 72%, respectively). Conclusion:The maximal ST/HR slope is more sensitive and specific than ST segment depression in the diagnosis of coronary heart disease. And it is of certain quantitative value in diagnosis of the number of stenosed coronary artery.