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目的:探讨平板运动试验(TET)过程中引起R波电压降低(R波低)或T波增高(T波高)的临床意义及其与冠状动脉(冠脉)病变的关系。方法:分析30例在TET中出现R波低或T波高患者的冠脉造影结果。结果:20例在TET中出现R波低,同时伴ST段水平压低(≥1mm,持续2min以上)4例,出现在V4～6导联16例,Ⅱ、Ⅲ、aVF导联4例;10例在试验中出现T波高,同时伴ST段压低2例,出现在V2～4导联8例,Ⅱ、Ⅲ、aVF导联2例;运动中发生心绞痛5例;30例冠脉造影结果显示:左前降支病变20例,回旋支4例,右冠脉2例,左前降支加右冠脉4例。行经皮腔内冠脉成形术30例,支架置入术26例。结论:TET诱发R波低或T波高是判断冠脉病变的可靠阳性指标。
Objective: To investigate the clinical significance of the decrease of R wave voltage (R wave low) or T wave elevation (T wave high) during treadmill exercise test (TET) and its relationship with coronary artery disease. Methods: The coronary angiographic findings of 30 patients with T-R wave or T wave were analyzed. Results: In 20 cases, there were 4 cases of low R wave in TET accompanied by ST depression (≥1mm for more than 2min), 16 cases of V4 ~ 6 leads, 4 cases of Ⅱ, Ⅲ and aVF leads, 10 Cases in the trial appeared T wave height, accompanied by ST segment depression in 2 cases, appeared in V2 ~ 4 lead in 8 cases, Ⅱ, Ⅲ, aVF lead in 2 cases; exercise occurred in 5 cases of angina; 30 cases of coronary angiography showed : Left anterior descending branch disease in 20 cases, 4 cases of supination, right coronary artery in 2 cases, right anterior descending coronary artery in 4 cases. Percutaneous transluminal coronary angioplasty in 30 cases, stent implantation in 26 cases. Conclusion: TET-induced low R wave or high T wave is a reliable and positive indicator of coronary artery disease.