摘要
目的:研究运动平板试验评价的心肌缺血与冠脉狭窄的相关性。方法:我院150例稳定型心绞痛患者,根据冠脉CT检查结果分为A组(狭窄<50%)、B组(狭窄50%~75%)、C组(狭窄>75%)三组,每组均50例。比较三组患者病变部位、冠脉狭窄率,运动试验患者ST段压低状况,采用Spearman法分析运动平板阳性率与冠脉狭窄的相关性。结果:与B组比较,C组冠脉直径狭窄率[(63.64±4.21)%比(66.71±4.46)%]及参考段血管直径[(2.92±0.23)mm比(3.03±0.21)mm]明显增加(P<0.05或<0.01);随着冠脉狭窄程度的加重,A、B、C三组运动试验中ST段压低出现时间明显缩短[(712.3±202.7)s比(602.3±210.4)s比(501.2±236.1)s];持续时间[(425.4±200.5)s比(520.8±205.8)s比(603.4±198.4)s]、运动试验阳性率(64.00%比82.00%比92.00%)明显增加;C组ST段压低幅度明显大于A组[(2.4±1.1)mV比(1.9±0.8)mV],P<0.05或<0.01。Spearman分析显示:运动试验阳性率(心肌缺血率)与冠脉狭窄程度无明显相关(r=3.425,P=0.126)。结论:尽管运动平板试验对于心肌缺血诊断具有重要的意义,但是冠状狭窄程度和患者心肌缺血程度并无明显相关性,值得临床注意。
Objective:To study correlation between treadmill exercise test assessing myocardial ischemia and coronary stenosis.Methods:A total of 150 patients with stable angina pectoris in our hospital,according to vascular stenosis by coronary CT were divided into group A(stenosis<50%,n=50),group B(stenosis 50%~75%,n=50)and group C(stenosis>75%,n=50).Coronary stenotic rate and ST depression during exercise test were compared among three groups.Spearman method was used to analyze correlation between treadmill exercise positive rate and coronary stenosis.Results:Compared with group B,there were significant rise in coronary diameter stenotic rate[(63.64±4.21)%vs.(66.71±4.46)%]and vascular diameter of reference segment[(2.92±0.23)mm vs.(3.03±0.21)mm]in group C,P<0.05 or<0.01.Along with coronary stenosis aggravated,there was significant reduction in onset time of ST depression[(712.3±202.7)s vs.(602.3±210.4)s vs.(501.2±236.1)s],and significant rise in duration[(425.4±200.5)s vs.(520.8±205.8)s vs.(603.4±198.4)s]and treadmill exercise positive rate(64.00% vs.82.00% vs.92.00%),in group A,B,C respectively;and ST depression extent of group C was significantly higher than that of group A[(2.4±1.1)mV vs.(1.9±0.8)mV],P<0.05 or<0.01.Spearman correlation analysis indicated that treadmill exercise positive rate(myocardial ischemia rate)was not significantly correlated with coronary stenotic degree(r=3.425,P=0.126).Conclusion:Although treadmill exercise test possesses important significance in diagnosis of myocardial ischemia,but coronary stenotic degree is not correlated with myocardial ischemic degree.which should raise clinical attention
引文
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