目的　探讨冠心病患者残余心肌缺血 (RI)的早期诊断方法。方法　经冠状动脉造影 (CAG)证实存在 RI的 82 3例患者均在 CAG前后 2周内行心电图 (ECG)、运动试验 (ET)、同位素心肌扫描和动态心电图检查 ,并进行平均 1年的随访。按文献报道方法将临床常用 7种检查的 2 6个指标与 CAG的 4个指标作变量逐一量化评分 ,进行非条件 L ogistic回归、逐步判别和判别分析。结果　 1心肌梗死 (MI)后心绞痛、静息心电图 ST段下移、次极量运动试验阳性、同位素可逆行心肌灌注缺损及 CAG有多支病变、次全闭塞者提示心脏事件发生率极高 ,证实对 RI的早期诊断有重要价值 ;2 RI程度对预测 MI患者的预后有重要意义。结论　 ECG或 ET示 ST段下移明显 ,冠脉三支病变 ,侧支循环差者为 RI的特征表现 ,应积极处理。 Objective To investigate the early diagnosis of residual myocardial ischemia (RI) in patients with coronary heart disease. Methods Totally 823 patients with RI confirmed by coronary angiography (CAG) underwent electrocardiogram (ECG), exercise test (ET), isotope myocardial scan and ambulatory electrocardiogram (ECG) within 2 weeks before and after CAG with an average follow-up of 1 year. According to the methods reported in the literature, 26 indicators of 7 kinds of tests and 4 indicators of CAG were used as quantitative variables one by one for non-conditional L ogistic regression, stepwise discrimination and discriminant analysis. Results 1 Post-myocardial infarction (MI) angina pectoris, ST-segment resting electrocardiogram, submaximal motor test positive, isotope reversible myocardial perfusion defects and CAG multi-vessel disease, subtotal occlusion prompted a high incidence of cardiac events, Confirmed the early diagnosis of RI has important value; 2 RI degree of prognosis of MI prognosis is of great significance. Conclusion ECG or ET showed ST segment down significantly, three coronary lesions, collateral circulation is characterized by poor performance of RI should be actively addressed.