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本研究以食道心房调搏超声心动图负荷试验方法,观察26例正常人和20例冠心病患者的左室收缩时间间期(STI)及心音图第二心音主动脉瓣成分至心动图二尖瓣曲线上 E 峰之时间(A_2E)的变化。结果显示,左室收缩功能指标射血前期(PEP)在正常对照组随起搏频率增快而逐步缩短(P<0.01),冠心病组则无明显变化。射血前期与射血期比值(PEP/LVET),冠心病组随起搏频率增快而逐步增大(P<0.05),正常组在起搏频率120次/分(BPM)时无明显变化,160BPM 时明显加大(P<0.05)。左室舒张功能指标 A_2E 在正常组随起搏频率增快而逐步缩短,160BPM 较120BPM 明显缩短(P<0.05),冠心病组则无明显改变。以起搏频率160BPM 时较调搏前 A_2E 缩短≤0.02秒及 PEP 与 A_2E 之和降低<0.04秒作为诊断冠心病的临界判断值,敏感性可分别达86%及79%。本文认为,此法为临床诊断冠心病提供了一种简单易行、安全可靠的方法。
In this study, esophageal atrial pacing echocardiography load test method to observe the 26 cases of normal subjects and 20 cases of coronary heart disease in patients with left ventricular systolic time (STI) and the second heart soundocardiography aortic valve component to the heart beats Changes in E-peak time (A_2E) on the flap curve. The results showed that left ventricular ejection fraction (PEP) was gradually shortened with the increase of pacing frequency in normal control group (P <0.01), but no change in coronary heart disease group. The ejection fraction and ejection fraction (PEP / LVET), coronary heart disease group increased gradually with the increase of pacing frequency (P <0.05), but there was no significant change in normal group at pacing rate of 120 BPM , Significantly increased at 160BPM (P <0.05). Left ventricular diastolic function index A_2E in the normal group with the rapid increase of pacing frequency and gradually shorten, 160BPM significantly shorter than 120BPM (P <0.05), coronary heart disease group had no significant change. The pacing rate of 160BPM was shorter than 0.02 seconds before A 2E and the decrease of the sum of PEP and A 2E was less than 0.04 seconds. As the critical diagnostic value of coronary heart disease, the sensitivity was 86% and 79% respectively. This article believes that this method for the clinical diagnosis of coronary heart disease provides a simple, safe and reliable method.