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负荷试验时出现的变化对于冠心病诊断的价值,过去已有评价,但对负荷试验诱发心绞痛的意义,尚无报道。本文研究极量踏车运动试验时发生的心绞痛与冠状意外(进行性心绞痛、心肌梗死、死亡)之间的关系。共随访1,402例极量踏车运动试验阳性的患者,讨论了他们在运动试验时发生心绞痛的意义。心绞痛根据病人主诉、疼痛持续时间、部位、严重程度等判定。终止运动的指征是,达到最大预期心率或发生心绞痛,心电图显示心肌缺血、心律失常、脉搏减慢和血压下降,极度疲乏等。运动试验的阳性标准是:ST段呈水平型或下垂型降低1.0毫米,或上斜型1.5毫米J点后0.08秒计算)。在4年随访中,运动试验既有ST段降低又有心绞痛的病人,每年冠状意外的发生率为不出现心绞痛病人的两倍,而7年随访中,前者冠状意外发生率为76％,后者为48％。
Changes in load test for the diagnosis of coronary heart disease value, in the past have been evaluated, but the significance of load-induced angina, has not been reported. This article studies the relationship between angina and coronary accidents (angina, myocardial infarction, and death) during a treadmill test. A total of 1,402 patients with positive treadmill tests were followed up to discuss the significance of angina pectoris during exercise testing. Angina according to the patient’s complaint, duration of pain, location, severity and so on. The indication of termination of exercise is to reach the maximum expected heart rate or angina pectoris, electrocardiogram shows myocardial ischemia, arrhythmia, pulse slowing and blood pressure, extreme fatigue and so on. The positive criteria for exercise testing are: reduction of ST segment by 1.0 mm for horizontal or sagittal, or 0.08 seconds after J-point for 1.5 mm incline. During the 4-year follow-up, patients who had both reduced ST-segment and angina pectoris at exercise testing had twice as many coronary accidents per year as patients without angina pectoris and 76% at the 7-year follow-up It is 48%.