平板运动试验中室性早搏ST段下移诊断冠状动脉病变的价值

探讨平板运动试验中室性早搏(VPCs)ST段下移程度对反映冠状动脉(简称冠脉)病变的价值。将休息和平板运动试验中均发生VPCs并且在3个月内进行冠脉造影的92例患者按冠脉造影结果分成冠心病组和非冠心病组,比较两组VPCsST段下移程度,下移程度与冠脉狭窄程度的关系以及VPCsST段下移诊断冠心病的价值。结果:冠心病组运动中VPCsST段下移及ST/R均大于非冠心病组。其中ST/R>10%对冠心病诊断灵敏度为91%,特异度为75%;对单支、2支、3支血管病变诊断灵敏度分别为84%、91%、100%。冠脉狭窄≥90%组运动中VPCsST段下移和ST/R大于狭窄为50%~69%组。结论:运动试验中VPCsST段下移可作为诊断冠心病的有效参考指标,其下移程度可能与冠脉狭窄程度有关。

The Value of ST Depression in Ventricular Premature Complexes During Treadmill Exercise Test to Diagnose Coronary Artery Disease

This study is to explore the value of ST depression in ventricular premature complexes(VPCs) during treadmill exercise test to reflect coronary artery disease(CAD). Ninety-two patients with VPCs at rest and during exercise were divided into the CAD group and the non- CAD group according to coronary arteriongraphy.The extent of ST depression in VPCs was compared in both groups.The relationship between ST depression and coronary artery stenosis was analyzed.The value of ST depression in VPCs to diagnose CAD was assessed. Results:The mean magnitude of ST depression in VPCs during exercise and mean ST depression /R-wave amplitude ratio (ST/R) in the CAD group were higher than those in non- CAD group .The sensitivity and specificity of ST/R>10% in VPCs during exercise in predicting CAD were 91%, 75% respectively. The sensitivity in diagnosing 1-vessel, 2-vessel and 3-vessel disease with this standard were 84%, 91% and 100% respectively. Compared with patients with 50%～69% coronary artery stenosis, patients with ≥90% stenosis had higher ST depression and ST/R in VPCs during exercise. Conclusion: During treadmill exercise test, ST depression in VPCs may be a useful index for diagnosing CAD.The magnitude of ST depression may be correlated with the severity of coronary artery stenosis.