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平板运动试验后心率恢复对冠心病的诊断价值

余意君   

  1. 武汉市普爱医院
  • 收稿日期:2010-10-09 修回日期:2010-11-26 出版日期:2011-03-15 发布日期:2011-03-15
  • 通讯作者: 余意君

The diagnostic value of heart rate recovery after treadmill exercise test for coronary artery disease

Yi-Jun YU   

  • Received:2010-10-09 Revised:2010-11-26 Published:2011-03-15 Online:2011-03-15
  • Contact: Yi-Jun YU

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摘要： 【摘要】 目的 评价平板运动试验后心率恢复对冠心病的诊断价值。方法 选择临床疑诊冠心病患者，根据冠状动脉造影检查结果分为冠心病组和非冠心病组。选择冠心病组和非冠心病组各86例进行平板运动试验，计算心率恢复及心率储备率并进行比较，利用心率恢复异常作为诊断冠心病标准以及ST段改变联合心率恢复异常作为诊断冠心病的标准与传统的ST段压低法比较。结果 冠心病组与非冠心病组比较，冠心病组心率恢复、运动最高心率及心率储备率均低于非冠心病组（P<0.05）。以心率恢复作为诊断冠心病的标准，与传统的ST段法比较，其敏感性差异无统计学意义（P>0.05），但特异性和准确性提高（P<0.05）；ST段改变联合心率恢复异常作为诊断冠心病的标准，特异性和准确性明显高于传统的ST段诊断标准（P<0.01）。结论 平板运动试验ST段改变联合心率恢复可提高冠心病诊断的准确性，心率恢复异常对于冠心病诊断有着重要的临床意义。

关键词: 平板运动试验, 心率恢复, 冠心病

Abstract: Abstract Objective: To evaluate the diagnostic value of heart rate recovery after treadmill exercise test for coronary artery disease (CAD). Method: Patients suspected for CAD were divided into CAD group and non-CAD (NCAD) group according to coronary angiography. Each eighty-six subjects underwent treadmill exercise test for both CAD group and non-CAD (NCAD) group. Heart rate recovery and the ratio of heart rate reserve between two groups were calculated and compared. The sensitivity and specificity were compared among the heart rate recovery, combined the ST segment change and the heart rate recovery, the ST segment change criteria for the diagnosis of CAD. Result: The heart rate recovery、the fastest heart rate in exercise and the ratio of heart rate reserve were lower in the CAD group than that of NCAD group (P<0.05).The two diagnostic methods had the same sensitivity（P>0.05）, but former had higher specificity and veracity(P<0.05). The two diagnostic methods combine had higher specificity and veracity (P<0.01). Conclusion: The combine of the ST segment change and the heart rate recovery after treadmill exercise test could improve the veracity of CAD. The abnormal heart rate recovery had important clinic significance for the diagnosis of CAD.

Key words: Treadmill exercise test, Heart rate recovery, Coronary artery disease