摘要
目的评价心脏变时性功能不全（chronotropic incompetence，CI）对冠心病的诊断价值。方法对183例临床疑诊冠心病患者，行平板运动试验和冠状动脉造影检查，依冠状动脉造影结果分为冠心病组（又分为单支病变组、双支病变组和多支病变组）和非冠心病组，分析各组间心脏变时性功能。结果以CI为诊断标准诊断冠心病的特异性和准确性均高于传统的ST标准（P〈0．05），但敏感性差异无显著性（P〉0．05），传统ST标准联合CI标准诊断冠心病的特异性和准确性高于单独运用传统ST标准和CI标准（P〈0．05），敏感性差异无显著性（P〉0．05）。冠心病各组运动后最大心率与变时性指数低于非冠心病组，并随病变冠状动脉支数的增加而减低（P〈0．05）冠心病伴三支病变组未达目标心率者多于单支和双支病变组，随受累冠状动脉支数增加，心脏变时性指数〈0．8者增多（P〈0．05）。结论CI可作为诊断冠心病的指标，CI联合ST段改变法对提高冠心病诊断的特异性和准确性具有重要意义；心脏变时性功能与冠心病冠状动脉病变支数呈负相关。
Objective To evaluate the diagnosis value of chronotropic incompetence in treadmill exercise test to patients with coronary artery disease （CAD）.Methods 183 cases of suspicious coronary disease who underwent treadmill exereise test were divided into CAD group and non-coronary artery disease （NCAD） group according to coronary artery angiogram and the chronotrpic response index and heart rate recovery at 1 minute after treadmill exercise test in CAD group showed obvious reducing compared with that in NCAD group. Result incompetence index and the ST segment criteria had the approximate sensitivity, but the former had higher accuracy. With the method combining traditional ST segment criteria with chronotropic incompetence, the diagnosing sensitivity, specificity and accuracy in CAD was 68.3%,90. 1% and 78.6% respectively. Conclusions Chronotropic incompetence in treadmill exercise test is a good method to diagnose CAD. The method of chronotropic incompetence in treadmill exercise test combined with traditional ST segment criteria is better than either of them.
出处
《国际医药卫生导报》
2010年第8期930-933,共4页
International Medicine and Health Guidance News
