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目的:探讨心电图平板运动试验阳性的患者,运动后收缩压恢复延迟与冠状动脉病变程度的相关性研究。方法:经症状限制性运动试验检查,并于30d内行冠状动脉造影患者。运动后收缩压恢复延迟定义为:运动后3min收缩压与运动后1min收缩压比值≥1.0,(即:收缩压恢复比值rSBPR3min/1min≥1.0)。冠状动脉病变程度的量化指标:应用杜克预后评分方法(分值范围0~100),将积分≥42确定为重度冠状动脉病变。入选164例年龄36~78岁,平均(57±8)岁,男性82%,重度冠状动脉病变患者73例(44%)。结果:收缩压恢复比值与冠状动脉病变严重程度杜克预后评分呈明显正相关(r=0.84,P<0.001)。二分类变量Logisitic回归分析,在调节运动SBP变化和临床情况等因素,收缩压恢复比值(rSBPR)仍能反映冠状动脉疾病严重程度OR=2.43(95%CI1.31~4.50)P=0.005。冠状动脉造影阳性组rSBPR较冠状动脉造影阴性组明显增高(P<0.05),但与是否合并高血压病无关(P>0.05)。结论:运动后收缩压恢复延迟与冠状动脉病变严重程度明显相关。
Objective: To investigate the correlation between the recovery of systolic pressure and the severity of coronary artery disease in patients with positive ECG treadmill exercise test. Methods: The symptoms of restricted exercise test, and within 30d underwent coronary angiography. Post-exercise systolic blood pressure recovery delay is defined as: 3min after exercise systolic blood pressure and 1min after exercise systolic blood pressure ratio ≥ 1.0, (ie: systolic blood pressure recovery ratio rSBPR3min / 1min ≥ 1.0). Coronary artery disease quantitative indicators: the use of Duke prognostic score (score range 0 to 100), the integral ≥ 42 determined as severe coronary lesions. A total of 164 patients aged 36-78 years (mean 57 ± 8 years), 82% of men and 73 patients (44%) of patients with severe coronary artery disease were enrolled. Results: The systolic blood pressure recovery ratio was positively correlated with the Duke prognostic score of severity of coronary artery disease (r = 0.84, P <0.001). In the dichotomous variables, Logisitic regression analysis showed that the SBP (rSBPR) still reflects the severity of coronary artery disease (OR = 2.43 (95% CI 1.31-4.50) P = 0.005) in adjusting SBP changes and clinical conditions. The rSBPR in coronary angiography positive group was significantly higher than that in coronary angiography negative group (P <0.05), but had no correlation with hypertension (P> 0.05). Conclusion: The recovery delay of systolic pressure after exercise is significantly correlated with the severity of coronary artery disease.