摘要
目的研究运动致 ST 段抬高在非心肌梗死患者中发生率及其临床意义。方法 2004年6月至2006年6月共有4601例患者接受了运动平板试验,其中有15例非心肌梗死患者出现 ST 段抬高,对这15例患者的临床特点与冠状动脉造影结果进行分析。结果 15例(3.2‰)运动致 ST 段抬高患者中,男性13例,女性2例,年龄40～75岁。单支病变者6例(40%),2支病变者6例(40%),3支病变者3例(20%);12例(80%)累及前降支,1例(6.6%)累及左主干,7例累及右冠状动脉,在累及前降支及左主干13例患者中有8例为重度狭窄病变(狭窄程度为90%～100%),所有ST 段抬高的导联均与病变血管的供血部位一致。结论运动致 ST 段抬高在非心肌梗死患者中发生率非常低,多因冠状动脉有严重的固定性狭窄,特别是前降支,可根据出现 ST 段抬高的导联判断缺血心肌的部位。
Objective To explore the incidence and angiographic features of exercise-induced ST- segment elevation in patients without prior myocardial infarction. Methods Exercise-induced ST-segment elevation occurred in 15 out of 4601 consecutive patients without prior myocardial infarction underwent treadmill exercise testing during a 2-year period. The coronary angiographic features of the 15 patients （ 13 males, aged between 40 -75 years ） were analyzed. Results Coronary angiography revealed one hemodynamically relevant stenotic vessel in 6 patients, two hemodynamically relevant stenotic vessels in 6 patients, three hemodynamically relevant stenotic vessels in 3 patients. Left anterior descending （LAD） coronary artery was affected in 12 patients. Left main coronary artery （LMCA） stenosis was evidenced in 1 patient and right coronary artery stenosis in 7 patients. Severe （90% - 100% ） occlusions were visualized in 8 out of 13 patients with LAD or LMCA lesions. Elevated ST-segment leads were consistent with the ischemic area where the blood supply of myocardium was affected by diseased vessels. Conclusions The incidence of exercise induced ST-segment elevation in patients without prior myocardial infarction is very low and mostly due to severe fixed coronary artery stenosis, especially in LAD. The location of ischemic myocardium can be suggested by ST-segment elevation leads during exercise.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2007年第7期641-644,共4页
Chinese Journal of Cardiology
