心率调整的ST段降低方法定性和定量检测冠心病的研究

目的探讨心率调整的ST段降低方法定性和定量检测冠心病的价值,并把ST/HR斜率和ST/HR指数两种指标和传统ST段指标进行了系统比较。方法选取2001年1月至2002年3月行平板运动ECG试验并在随后3周内住院行冠状动脉造影的可疑冠心病患者共173例,应用Cornell运动试验方案,分别测定并计算运动试验过程中ST段变化值及ST/HR斜率和ST/HR指数值,以冠状动脉造影结果作为诊断冠心病的标准。结果传统ST段指标、ST/HR斜率和ST/HR指数诊断冠心病的敏感性分别为68%、86%和81%,特异性分别为70%、85%和81%。ST/HR斜率和ST/HR指数诊断冠心病的敏感性、特异性均明显高于传统ST段指标(P<0.05)。传统ST段指标(ST段降低≥0.2mV)、ST/HR斜率和ST/HR指数定量识别冠心病3支血管病变的敏感性分别为30%、81%和64%,特异性分别为70%、65%和69%。ST/HR斜率和ST/HR指数识别冠心病3支血管病变的敏感性显著高于传统ST段指标(P<0.001),特异性无显著性差异(P>0.05)。结论心率调整的ST段降低指标、ST/HR斜率和ST/HR指数与传统ST段指标相比能明显提高运动ECG试验定性诊断冠心病的敏感性和特异性。与传统ST段指标相比,ST/HR斜率和ST/HR指数明显提高了运动ECG试验定量识别冠心病3支血管病变的敏感性。

Heart rate adjustment of ST segment depression for identifying and quantifying coronary arteriosclerosis disease

Objective To assess the effect of heart rate adjustment of ST segment depression for identifying and quantifying coronary artery disease and compare both ST / HR slope and ST / HR index with standard ST segment depression criteria. Mthods One hundred and seventy three patients with suspected coronary artery disease were referred for a routine treadmill exercise electrocardiogram, and subsequently underwent selective coronary angiography within 3 weeks. The magnitude of ST segment depression, ST / HR slope and ST / HR index calculations are performed by a computerized ECG system, with exercise according to the Cornell protocol. CAD was defined by coronary angiography. Results In our study , standard electrocardiographic criteria?ST / HR slope criteria and ST / HR index criteria identified CAD with a sensitivity of 68%?86% and 81% respectively, with a specificity of 70%?85% and 81% respectively. Sensitivity and specificity for CAD of ST / HR slope and ST / HR index were all significantly greater than that of Standard electrocardiographic test criteria (P<0.05=. Standard electrocardiographic criteria?ST / HR slope criteria and ST / HR index criteria identified 3-vessel CAD with a sensitivity of 30%?81% and 64% respectively, with a specificity of 70%?65% and 69% respectively. Sensitivity for 3-vessel CAD of ST / HR slope and ST/HR index were all significantly greater than that of Standard electrocardiographic test criteria(P<0.001=,with no significantly change in specificity (P>0.05). Conclusions In this study, these findings suggested that sensitivity and specificity for identifying CAD of ST / HR slope and ST / HR index were all significantly greater than that of Standard electrocardiographic test criteria in selected patients. Sensitivity for identifying 3-vessel CAD of ST / HR slope and ST /HR index were significantly increased compared with Standard electrocardiographic test criteria, with no significantly change in specificity.