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目的:探讨运动平板试验预测高原心肌低氧症的价值。方法:随机选择190例位于海拔2 200m经健康体检的铁路工人作为研究对象,采用心电分析系统对其进行运动平板试验。然后全体进入海拔(4 700~5 072)m的青藏线格拉段施工12个月期间再测定其心电图,并将缺血性心电图患病率与运动平板试验阳性率进行对比。结果:1在海拔2 200m时的运动平板试验总阳性率与海拔(4 700~5 072)m时的心电图总阳性率无统计学差异(P>0.05),且具有较高的特异度、阴性预测值以及中等程度的阳性预测值等;2运动平板心电图阴性组与阳性组存在统计学差异的生理学参数包括:运动后6min呼吸、运动前舒张压、运动终点舒张压、运动后6min收缩压以及运动后6min舒张压。结论:运动平板试验能够很好地预测高原心肌低氧症,其得出的心电图结果能够作为高原心肌低氧症的重要判定标准。
Objective: To investigate the value of exercise treadmill test in predicting plateau myocardial hypoxia. Methods: A total of 190 railway workers at a healthy elevation of 2 200 m above sea level were randomly selected as the study subjects, and their electrocardiographic analysis system was used to conduct the treadmill test. Then all the patients went into the Gela section of Qinghai-Tibet line at an elevation of (4 700 ~ 5 072) m and then measured their ECG during 12 months’ construction. The prevalence of ischemic electrocardiogram was compared with the positive rate of treadmill test. Results: 1 The total positive rate of treadmill test at 2 200 m altitude was not significantly different from the total positive rate of electrocardiogram at 4 700 ~ 5 072 m (P> 0.05), and it had high specificity and negative Predictors, and moderate positive predictive value. 2 Physiological parameters of the treadmill ECG negative group and the positive group include: respiration, pre-exercise diastolic pressure, diastolic end-diastolic pressure, systolic pressure at 6 min after exercise, Diastolic pressure 6min after exercise. Conclusion: The treadmill exercise test can predict plateau myocardial hypoxia well, and the electrocardiogram results can be used as an important criterion for plateau myocardial hypoxia.