微伏级T 波电交替及ST/HR 指数 对冠心病的诊断价值

Diagnostic value of microvolt T-wave alternants and ST/HR index in coronary heart disease

摘要:

目的 研究平板运动试验（TET）阳性患者的临床资料及TET 各参数。方法 245 例TET 阳性患 者经冠状动脉造影（CAG）检查分为冠心病（CHD）组和非CHD 组，收集临床资料，对两组患者的临床资 料及TET 各参数进行分析研究。结果 和非CHD 组比较，CHD 组男性、年龄增大、高血压、糖尿病、吸烟、 CHD 家族史、基础收缩压、峰值心率、运动最大心率与预计最大心率比值（rHR）、心率储备使用率（HRR）、 微伏级T 波电交替（MTWA）及ST/HR 指数均是CHD 的危险因素（P <0.05）；Logistic 回归分析显示，男 性、糖尿病、CHD 家族史、HRR 及MTWA 是CHD 的危险因素；ROC 曲线下面积分析：MTWA（AUC ： 0.578，P =0.038）和ST/HR 指数（AUC ：0.669，P =0.034）是较好的预测指标。结论 男性、糖尿病、CHD 家族史、HRR 及MTWA 是CHD 的危险因素；MTWA 及ST/HR 指数可提高TET 诊断CHD 的准确性。

Abstract:

Objective To investigate the prognostic value of microvolt T-wave alternants and ST/HR index in patients with positive result in treadmill exercise test (TET). Methods A total of 245 patients with positive result in TET were included in the study, and they were divided into coronary heart disease (CHD) group and non CHD group based on coronary angiography. Results Gender, age, hypertension, diabetes, smoking, family history of CHD, basic systolic pressure, the maximum heart rate, the ratio of the maximum heart rate over expected maximum heart rate (rHR), heart rate reserve (HRR), microvolt T-wave alternants (MTWA), and ST/HR index were risk factors for CHD (P < 0.05). Logistic regression analysis indicated that male, diabetes, family history of CHD, HRR, and MTWA were independent risk factors for CHD. Area under the curve (AUC) analysis suggested that MTWA (AUC: 0.578, P = 0.038) and ST/HR index (AUC: 0.669, P = 0.034) were promising diagnostic biomarker for CHD. Conclusion MTWA and ST/HR index can inprove the accuracy of TET in diagnosing CHD.