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目的 探讨活动平板试验(TET)和冠状动脉造影(CAG)诊断冠心病的相关性,以及TET的ST段压低和冠状动脉病变的对应关系。方法 典型胸痛患者182例,男119例、女63例,年龄38～67岁。停用抗心绞痛药物至少5个半衰期,行TET及CAG,如TET阳性而CAG正常再行潘生丁试验、心肌核素显像、超声多巴酚丁胺负荷试验。结果 182例中TET阳性138例,CAG证实至少1支血管狭窄≥50％者121例。TET阴性伴CAG正常者31例。138例TET阳性患者,CAG正常19例。TET诊断冠心病的敏感性、特异性、准确性分别为88.3％、62.0％、86.2％。左前降支病变几乎无例外都反映在V_1～V_6导联ST段压低,右冠脉病变反映在Ⅱ、Ⅲ、aVF导联ST段压低。19例TET阳性但CAG正常者,有9例经检查证实为冠脉微血管病变。结论 TET为诊断冠心病的有效方法之一,冠脉病变部位和运动心电图ST段压低有一定对应关系,对心脏功能评价有独到之处。
Objective To investigate the relationship between treadmill test (TET) and coronary angiography (CAG) in the diagnosis of coronary heart disease and the relationship between ST segment depression and coronary artery lesion in TET. Methods A total of 182 patients with typical chest pain, 119 males and 63 females, aged 38 to 67 years. Disable anti-anginal drugs at least 5 half-lives, line TET and CAG, such as TET-positive and CAG normal dipyridamole test, myocardial imaging, dobutamine stress ultrasound test. Results Of the 182 cases, 138 were positive for TET. CAG confirmed at least 1 vessel stenosis ≥50% in 121 cases. TET negative with normal CAG in 31 cases. 138 cases of TET positive patients, normal CAG in 19 cases. The sensitivity, specificity and accuracy of TET in diagnosis of coronary heart disease were 88.3%, 62.0% and 86.2%, respectively. Left anterior descending branch of the lesion with almost exception are reflected in the V_1 ~ V_6 lead ST segment depression, right coronary artery lesions reflected in Ⅱ, Ⅲ, aVF lead ST segment depression. Nineteen patients with positive TET but normal CAG had nine cases confirmed as coronary microvascular lesions. Conclusion TET is one of the effective methods to diagnose coronary heart disease. There is a certain relationship between coronary lesion and ST-segment depression of exercise ECG, which is unique to cardiac function evaluation.