平板运动试验与冠状动脉造影对冠心病危险分层的意义

目的评估平板运动试验在心肌缺血诊断、危险分层方面的价值和意义。方法对均进行平板运动试验及冠状动脉造影两项检查的52例患者进行观察和分析,对平板试验阳性者28例、平板试验阴性者24例与各自的冠状动脉造影对比,评判平板运动试验对胸痛、胸闷等不同症状患者心肌缺血程度初步估测,进行危险评估。结果活动平板运动试验检测心肌缺血的灵敏度为96%,特异性88%,预测阳性值为89%,ST段的下移形态、程度及导联数是评估的重要指标。对冠状动脉造影中血管狭窄85%以上、平板运动试验阳性的18例中的8例(强阳性)行PTCA术,其余10例用药物治疗,疗效满意。结论活动平板运动试验对缺血性心脏病的诊断价值是可以肯定的,对冠心病进行危险分层及选择治疗、评估预后有重要意义。

Significance of treadmill exercise test and coronary angiography in risk stratification

Aim To evaluate the efficacy of treadmill exercise test (TET) in the di agnosis of myocardial ischemia and risk stratification.Methods TET and coronary angiography (CAG) were both performed in 52 patients, including 14 cases of typi cal cardiac angina, 3 cases of acute myocardial infarction, 6 cases of old myoca rdial infarction, 26 cases of atypical chest pain and 3 cases of risk factor of coronary heart disease. 28 cases underwent TET to show the positive, 22 males an d 6 females with a mean age of 47.8 years, while the other 24 cases showed the n egative, 17 males and 7 females with a mean age of 45.9 years, then compared wit h CAG respectively. Risk evaluation was conducted in the effect of TET on myocar dial infarction in all the patients.Results The sensitivity of TET detecting myo cardial infarction was 96%, the specificity was 85%, and the predictive positi ve value was 86%. The conformation, degree and lead numbers of ST segment depre ssion were the important indices. 8 cases with strong positive among 18 TET posi tive patients (narrow degree of blood vessel was 85%from CAG) received percutan eous transluminal coronary angioplasty (PTCA), and the other 10 patients receive d drug therapy, with a satisfying efficacy. Conclusion TET has an affirmative va lue in the diagnosis of myocardial ischemia, and has an important significance i n the risk stratification, choice of therapy and prognosis evaluation.