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冠状动脉疾病(CAD)患者的心肌缺血主要表现为心绞痛,但有些 CAD 患者仅有隐性心肌缺血,原因不明。本文作者研究了 CAD 患者运动试验时,隐性心肌缺血的诊断和预后价值。研究对象包括15个心导管中心共2982例。冠脉造影确诊 CAD(冠脉直径狭窄≥70％)者1583例。再将患者分为4组:组Ⅰ424例,运动时 ST 段下降≥1mm,但无胸痛;组Ⅱ232例,运动引起胸痛,但无 ST 段移位;组Ⅲ456例,运动引起胸痛伴 ST 段下降;组Ⅳ471例,运动时无胸痛也无 ST 段移位。组Ⅰ和Ⅱ临床特征相似,多支 CAD 人数各为63％和55％(无意义);但组Ⅰ中有心绞痛病史行人数较少(P<0.01)。组Ⅲ与Ⅰ相比,重度心绞痛人数较
Myocardial ischemia in patients with coronary artery disease (CAD) mainly presents with angina pectoris, although some CAD patients have only occult myocardial ischemia for unknown reasons. The authors studied the diagnosis and prognostic value of occult myocardial ischemia in patients with CAD. A total of 2982 cardiac catheterization centers were included in the study. Coronary angiography confirmed CAD (coronary stenosis ≥ 70%) were 1583 cases. The patients were divided into 4 groups: group I424 cases, exercise ST segment decreased ≥ 1mm, but no chest pain; group Ⅱ 232 cases, exercise caused by chest pain, but no ST segment displacement; group Ⅲ456 cases, exercise caused chest pain with ST segment decline ; Group Ⅳ471 cases, exercise without chest pain nor ST segment displacement. The clinical features of groups Ⅰ and Ⅱ were similar. The number of CAD patients was 63% and 55% respectively (meaningless). However, there were fewer patients with history of angina in group Ⅰ (P <0.01). Group Ⅲ and Ⅰ compared to the number of patients with severe angina