活动平板运动实验最大ST/HR斜率与冠状动脉造影结果对照分析

目的 探讨运动实验最大ST/HR斜率与冠状动脉病变程度的关系。 方法 拟诊冠心病(CHD)患者280例2周内行活动平板运动实验与冠状动脉造影检查，根据冠状动脉造影结果分为冠心病组和非冠心病组，比较2组活动平板运动实验ST/HR斜率值与冠状动脉病变的程度。 结果 运动ST/HR斜率[≥2.2 μV/(次·min)]值CHD组明显高于非CHD组，P＜0.01；而METs明显低于非CHD组,P＜0.01。随冠状动脉病变严重程度的增加,运动ST/HR斜率值逐渐增大，ST/HR斜率≥2.2 μV/(次·min)，1支血管病变为28.98%；ST/HR斜率≥4.0 μV/(次·min)，2支血管病变为32.60%；ST/HR斜率≥6.0 μV/(次·min)，3支血管病变为38.40%，血管病变支数与病例比较，P＜0.05。运动ST/HR斜率值与ST段压低值及冠状动脉病变严重程度均呈正相关；运动最大代谢当量(METs)与ST段压低及冠状动脉病变严重程度呈负相关。 结论 冠心病患者运动ST/HR斜率增大可反映心肌缺血及冠状动脉病变程度的指标。 

Relationship between the exercise maximal ST segment / heart rate slope and coronary angiography

Objective To study the relationship between the exercise maximal ST segment/heart rate slope(ST/HR slope) and coronary angiography in patients with coronary artery disease(CHD). Methods Total 280 patients with suspected CHD received treadmill exercise test and coronary angiography in two weeks,and were divided into CHD group and non-CHD group according to the results of coronary angiography.The exercise maximal ST segment/heart rate slope and the severity of coronary arterial lesions were compared between the two groups. Results The exercise maximal ST segment/heart rate in CHD group was significantly higher than that in non-CHD group(P＜0.01),and the metabolic equivalents(METs) in CHD group was significantly lower than that in non-CHD group(P＜0.01).If ST/HR slope≥2.2 μV/(bp·min),1 branch coronary artery vessel disease accounted for 28.98%;ST/HR slope≥4.0 μV/(bp·min),2 branch coronary artery vessel disease accounted for 32.60%;ST/HR slope≥6.0 μV/(bp·min),3 branch coronary artery vessel disease accounted for 38.40%(P＜0.05).The exercise maximal ST/HR slop was positively correlated to the depression of ST segment and the severity of coronary artery lesion.The maximal(METs) was negatively correlated to ST segment depression and the severity of coronary arterial lesions. Conclusion The increase of exercise maximal ST segment/heart rate in patients with CHD may show the myocardial ischemia and the severity of coronary arterial lesions.