平板运动试验评分与冠状动脉病变的关系

目的探讨平板运动试验评分即Duke评分(DTS)与冠状动脉病变严重程度之间的相关性。方法分析219例在同期内先后接受平板运动试验(TET)和冠状动脉造影(CAG)检查病例的临床和心电图资料,揭示不同程度和范围的冠状动脉病变和Duke评分的相关性。结果Duke评分与冠心病高危因素(高血压、糖尿病、高脂血症)呈明显相关性(P<0.05)。Duke评分与冠脉病变的严重程度和范围呈明显相关性(P<0.001)。低危Duke评分组47例无>75%狭窄,8例1支血管>75%狭窄,13例2支血管>75%狭窄或前降支病变,2例3支血管>75%狭窄或左主干病变;中危Duke评分组22例无>75%狭窄,13例1支血管>75%狭窄,51例2支血管>75%狭窄或前降支病变,9例3支血管>75%狭窄或左主干病变;相比而言,高危Duke评分组1例无>75%狭窄,2例1支血管>75%狭窄,18例2支血管>75%狭窄或前降支病变,33例3支血管>75%狭窄或左主干病变。结论Duke评分综合了临床资料、冠状动脉解剖及左室射血分数等预测因素,可作为预测有意义的冠脉病变的一个独立因素。该评分方法除了提供准确的预后评价,而且可以预测冠脉病变严重程度。

The correlation of Duke treadmill score (DTS) and the extent of coronary artery disease

Objective To investigate the correlation of Duke treadmill score (DTS) and the extent of coronary artery disease. Methods we analyzed the clinic and electrocardiographic data of 219 patients who underwent both treadmill exercise test and coronary Angiography(CAG). To reveal the correlation of the extent of coronary artery disease and Duke treadmill score. Results Duke treadmill score and high-risk factors(hypertension, diabetes, hyperlipemia ) of coronary artery disease present positive correlation(P<0.05);Duke treadmill score and the extent ofcoronary artery disease also show positive correlation(P<0.001).Within low-risk DTS group, 47 patients have no coronary stenosis>75%, 8 patients have 1-vessel coronary lesion>75%, and 13 patients have 2-vessel corommy lesion>75%, only 2 patients have 3-vessel coronary lesion>75% or left main disease. Within moderate risk DTS group, 22 patients have no coronary stenosis>75%, 13 patients have 1-vessel coronary lesion>75%, and 51 patients have 2-vessel coronary lesion>75%. 9 patients have 3-vessel coronary lesion>75% or left main disease. By comparison, within high-risk DTS group, only 1 patient has no coronary stenosis>75%, 2 patients have 1-vessel coronary lesion>75%, and 18 patients have 2-vessel coronary lesion>75%, 33 patients have 3-vessel coronary lesion>75% or left disease. Conclusions Duke treadmill score combine the prognostic factors of clinical data, coronary artery anatomy and left ventricular ejection fraction etc, and also is an independent factor in prognosis of significant coronary artery disease. The composite DTS not only provides accurate prognostic evaluation, but also predicts the severity of coronary artery diseases.