食道心房调搏心负荷试验诊断冠心病的价值

目的探讨食道心房调搏心负荷试验（ＴＥＡＰ）诊断冠心病的价值，并与活动平板运动试验（ＴＭＥＴ）进行对比，同时对冠状动脉病变程度进行评估。方法自１９９３年５月～１９９７年１０月，８０例拟诊冠心病的住院病人同期行ＴＥＡＰ、ＴＭＥＴ及ＣＡＧ检查；以ＣＡＧ为诊断标准，确诊为ＣＨＤ者６０例，另２０例为ＣＡＧ正常者。ＣＡＧ均为右股动脉Ｓｅｌｄｉｎｇｅｒ法穿刺，ＪｕｄｋｉｎＳ法进行。ＴＥＡＰ、ＴＭＥＴ以心率达到次极限水平，二阶梯运动试验方法记录ＥＣＧ。结果ＴＥＡＰ诊断ＣＨＤ的敏感性、特异性为８１．６７％、９０％，并且与ＣＨＤ患者冠状动脉病变支数呈正相关。其与ＴＭＥＴ的敏感性、特异性相比更可靠（Ｐ＜０．０１）。结论食道心房调搏心负荷试验可以作为一种无创伤性、有效、简便的诊断ＣＨＤ的方法。并可对冠状动脉病变程度进行初略评估。

Diagnostic value of transesophageal atrial pacing test in coronary heart disease

Object To find out diagnostic value of transesophageal atrial pacing test (TEAP)and treadmill exercise test (TMET) in the coronary heart disease (CHD) , and to appraise coronary lesion degree.Methods 80 patientswere diagnosed clinically as CHD and checked by TEAP . TMET and coronary angiography (CAG) from May 1993 to Oct 1997 . 60 cases were CHD patients depended on CAG , 20 cases were normal . CAG were operated to Judkins method with the method of Seldinger's puncture right arteria femoralis . When heart reat achieved the level of submaximal exercise test according to master's method, electrocardiogram (ECG) was recorded in TEAP and TMET.Results Sensitity and specificity of TEAP and TMET were respectively 81.67% , 90% , 75% , 70% . TEAP was in the direct radio with coronary lesion degree in patients of CHD .Conclusion TEAP was a noninvasic , simple , sensitive way for CHD , and could be used to evaluate coronary lesion degree .