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目的以冠状动脉造影(CAG)结果为标准,评价平板运动试验(TET)对冠心病介入治疗(PCI)术后支架内再狭窄及新发病变的定位诊断价值。方法对介入治疗术后6～9个月同时完成TET和CAG的923例患者进行回顾性分析。结果 923例介入治疗术后TET与CAG均阳性144例患者中,①单支病变中,前降支(LAD)与V2～V6导联下移有关,准确度75.3%,与其它导联组比较χ2=154.56,p<0.01;回旋支(LCX)与Ⅱ、Ⅲ、aVF导联下移有关,准确度33.3%,与其它导联组比较χ2=10.92,p>0.05;右冠状动脉(RCA)与Ⅱ、Ⅲ、aVF、V4～V6导联下移有关,准确度60.2%,与其它导联组比较χ2=96.12,p<0.01;②双支病变中(LCX/LAD+LAD/RCA+LCX/RCA)均以Ⅱ、Ⅲ、aVF、V4～V6导联ST段下移为主,准确度47.3%,与其它导联组比较χ2=13.51,p>0.05;③三支病变中涉及的导联包括Ⅰ、Ⅱ、Ⅲ、aVF、V4～V6,其准确度为68.2%,与其它导联组比较χ2=29.31,p<0.01。结论平板运动试验对于评价介入治疗术后支架内再狭窄及新发病变的定位有很高的临床诊断价值。
Objective To evaluate the diagnostic value of treadmill exercise test (TET) in the diagnosis of in-stent restenosis and new lesions after coronary intervention (PCI) based on the results of coronary angiography (CAG). Methods A total of 923 patients with TET and CAG who completed 6 to 9 months after PCI were retrospectively analyzed. Results Among the 923 patients with positive TET and CAG after the interventional treatment, in the single vessel disease, the anterior descending artery (LAD) was associated with the descending of the V2 ~ V6 lead with an accuracy of 75.3%. Compared with other lead groups (χ2 = 154.56, p <0.01). The degree of gyrus branch (LCX) was related to the decrease of lead of Ⅱ, Ⅲ and aVF with the accuracy of 33.3%. Compared with other lead group, χ2 = 10.92, (P <0.01) .②The positive rate of LCX / LAD + LAD / RCA + LCX in double-vessel disease was significantly higher than that in other lead group (χ2 = 96.12, p <0.01) / RCA) were mainly in the ST segment of Ⅱ, Ⅲ, aVF and V4 ~ V6 leads, the accuracy was 47.3%, compared with other lead group χ2 = 13.51, p> 0.05; Including Ⅰ, Ⅱ, Ⅲ, aVF, V4 ~ V6, the accuracy of 68.2%, compared with other lead group χ2 = 29.31, p <0.01. Conclusion The treadmill exercise test has a high clinical value for evaluating the location of in-stent restenosis and new lesions after interventional therapy.