活动平板运动试验诱发ST段抬高的临床意义

Clinical Significance of Exercise-induced ST Segment Elevation

为探讨活动平板运动试验诱发ST段抬高的临床意义 ,分析了 9例无心肌梗死 (简称心梗 )而运动诱发ST段抬高的静息心电图、运动试验及冠状动脉 (简称冠脉 )造影检查结果。结果 :5 0 5 5例行平板运动试验者中 ,有 11例未患心肌梗死而运动诱发心绞痛伴ST段抬高 ,发生率 0 .2 2 %。其中 ,8例患者作了进一步检查 ,冠脉造影显示均有程度不等的血管病变 ,缺血相关血管的狭窄达到 5 0 %～ 10 0 %。ST段抬高导联与缺血相关血管有良好对应关系。另有 1例患者于运动试验 1周后死于心脏性猝死。结论 :无心梗患者运动诱发心电图ST段抬高是冠脉痉挛或冠脉严重狭窄所致心肌局部缺血的标志。

To investigate the clinical significance of exercise-induced ST segment elevation.Retrospective analysis of resting electrocardiogram,treadmill exercise test and the results of coronary angiography was made in patients without myocardial infarction who had ST segment elevation during treadmill exercise test. Results:11 of 5 055 patients who underwent test in our hospital complained chest pain and got ST segment elevation during treadmill exercise test. 8 of them underwent coronary angiography ,all patients demonstrated 50%～100% stenosis of coronary artery.The leads of ST segment elevation are well correlated with the ischemia-related artery.A patient died from ventricular fibrillation one week after treadmill exercise test. Conclusion: It is a sign of myocardial ischemia resulting from spasm or severe stenosis of proximal coronary artery that exercise-induced ST segment elevation in patients without myocardial infarction.