【摘要】 目的探讨心率恢复性(HRR)活动平板试验(TET)中诊断冠心病(CHD)的临床意义。方法选取拟诊冠心病者110例行TET在检查,并于检查后2周内行冠状动脉造影(CAG),以是否植入支架分为支架植入(A组)66例与非支架植入(B组)44例,比较2组TET参数:包括ST段、最大ST/HR斜率(ST/HR)、HRR、收缩压恢复比(rSBP)等。结果A组ST段、ST/RR和rSBP指标均高于B组,差异有统计学意义(P<0.05,P<0.01),而HRR明显低于B组,差异有统计学意义(P<0.01)。比较TET各种指标的诊断价值,ST段指标敏感度最高为93.9%,rSBP敏感度次之为90.9%,最大ST/HR斜率的敏感度为89.4%,HRR敏感度最低为87.9%;HRR特异度为90.9%、正确指数为78.0%。HRR指标与ST指标、最大ST/HR斜率、rSBP结合,敏感度分别为90.1%、86.2%、85.4%,特异度分别为72.3%、77.4%、87.0%。结论HRR有较高的特异度,与其他指标结合可用于冠心病的诊断。更多还原

【Abstract】 Objective To investigate the clinical significance of heart rate recovery(HRR) by treadmill exercise test(TET) in diagnosis of coronary heart disease(CHD).Methods One hundred and ten patients who were suspected coronary heart disease were selected to receive TET examination,and underwent coronary artery angiography(CAG) 2 week after the TET examination,according to whether implanted stent or not,they were divided into stent implantation group(group A) with66 cases and non-stent implantation group(group B) with 44 cases,the TET parameters included section ST,maximum ST/HR slope(ST/HR),HRR,the ratio of systolic blood pressure(rSBP) etc were compared between the two groups.Results In group A,the index of ST segment,ST/RR and rSBP were higher than in group B,the difference was statistically significant(P <0.05,P <0.01),while HRR was lower than that in group B,the difference was statistically significant(P <0.01).To compare the diagnostic value of various indexes of TET,ST segment’ s highest sensitivity was 93.9%,the sensitivity of rSBP was 90.9%,the maximum ST/ HR slope’ s sensitivity was 89.4%,the sensitivity of HRR was 87.9%;HRR’ s specificity was 90.9%,the correct index was 78.0%.HRR index combined with ST index,maximal ST/HR slope and rSBP,the sensitivity was 90.1%,86.2%and 85.4%respectively,the specificity was 72.3%,77.4%and 87.0%respectively.Conclusion The specificity of HRR is high,combined with other indicators,it can be used for the diagnosis of coronary heart disease.更多还原