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本文评价运动试验时无症状性心肌缺血的诊断和预后意义,并与运动试验时出现心绞痛者进行比较.2982例资料取自冠状动脉外科研究登记处.经冠状动脉造影检查:1583例左主干狭窄(内径缩小≥50%)或某主支狭窄(内径缩小≥70%),为明显冠状动脉病变(CAD);1117例非明显CAD;282例无CAD.造影后一个月内按标准或修订的Bruce方案进行活动平板试验,凡ST段水平型或下垂型(较静息时)压低≥1mm且持续≥0.08S,或者出现心绞痛,为阳性.各例逐年随访达7年(至少5年),99%病例完成随访.明显CAD者根据运动试验结果分组:424例(组Ⅰ)缺血性ST段压低组无心绞痛;232例(组Ⅱ)出现心绞痛但无缺血性ST段压低;456例(组Ⅲ)兼有缺血性ST段压低和心绞痛;471例(组Ⅳ)既无ST段压低也无心绞痛.
This article evaluates the diagnostic and prognostic significance of asymptomatic myocardial ischemia during exercise testing and compares them with those who develop angina during exercise testing.2,982 patients are enrolled in the Registry of Coronary Artery Surgery by coronary angiography: 1583 cases of left main trunk Stenosis (diameter reduction ≥50%) or a stenosis (diameter reduction ≥70%), significant coronary artery disease (CAD); 1117 cases of non-significant CAD; 282 cases without CAD. Within one month after angiography standard or revision Bruce regimen for active treadmill test, where ST-segment horizontal or sagging type (at rest) pressure ≥ 1mm and continued ≥ 0.08S, or angina pectoris, positive for each case of annual follow-up up to 7 years (at least 5 years) , 99% of patients were followed up.Everyone with CAD was divided according to the results of exercise test: 424 patients (group Ⅰ) had no angina pectoris in ischemic ST segment depression, 232 patients (group Ⅱ) had angina pectoris but no ischemic ST segment depression, 456 Cases (group Ⅲ) both ischemic ST segment depression and angina pectoris; 471 cases (group Ⅳ) neither ST segment depression nor angina pectoris.