心脏变时功能不全对冠心病严重度的预测价值.pdfVIP

· 820· 志2007年12月第24卷第12期 J Clin Intern Med，December2007． vo1．24．No．12 · 论著 · 心脏变时功能不全对冠心病严重度 的预测价值 冯应君 杨汉东 闵新文 陈欣 王波 [中图分类号]R541．4 [文献标识码]A [文章编号]1001-9057(2007)12-0820-03 [摘要] 目的 探讨变时功能不全与冠心病严重度的关系。方法 经选择性冠状动脉造影 确诊的91例冠心病患者分为单支病变组(30例)、双支病变组(31例)和三支病变组(30例)，所有 患者完成亚极量运动负荷试验并计算变时功能指标运动最高心率与预测最大心率值之比(rHR)和 心率储备率(HRR)。结果 rHR和HRR在双支病变和三支病变组显著低于单支病变组(P0． 01)，而双支病变和三支病变组问比较差异无显著性(P0．05)；冠心病患者中HRR0．72预测多 支病变的OR为4．67(95％CI 1．8—12．1)，预测冠脉狭窄≥75％的OR为3．06(95％CI 1．1—8． 3)。结论 冠心病多支病变患者变时功能降低更严重，变时功能不全可能对冠心病多支病变和冠 脉狭窄程度有预测价值。 [关键词] 冠心病； 冠状动脉造影； 运动试验； 变时功能 Chronotropic incompetence predicts angiographic severity in patients with coronary artery disease FENG n，YANG Handong，MINXinwen，et al,Dongfeng Subsidiary Hospital ofYunyang Medical Colleges ofHubei Province，Shb~n 442000，China [Abstract] Objective To investigate the relationship between the chronotropic incompetence and angiographic severity of coronary disease．Methods 91 patients with atherosclerotic berat disease(CHD) were diagnosised by coronary anglography and were divided to 3 groups：CHD group with only one coronary artery involved(CHD1 group，30 patients)，CHD group with two coronary artery involved(CHD2 group， 31 patients)，CHD group wit}l three coronary artery involved(CHD3 group，30 patients)．A month before coronary angiography，symptom-limited exercise treadmill tests had been accomplished，the chronotropic response had been measured and expressed aS ratio of heart rate reserve(HRR)and the percent maximal age．predicted heart rate achieved(rHR)．Results rHR and HRR were very significantly lower(all P 0．01)in CHD2 and CHD3 group than that in CHD1 group，but similar between between CHD2 group and CHD3 group(P0．05)．HRR0．72 Can predicts multi—branches stenosls(OR 4．67，P0．01)and≥ 75％ coronary artery stenesis(0R3．06，P0．01)inCHD patients．Conclusion Ch