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自Master于1929年首创二级梯心电图运动试验以来,经过长期探索和不断完善,心电图运动试验已成为目前公认的最重要的冠心病无创诊断方法和评价治疗效果的较好指标。心电图运动试验的评价,一向以ST段偏移作为标准,它比较可靠而又受普遍重视,其敏感性为60％～70％,特异性为85％～90％。但也有人认为,作为正常人群普查冠心病的手段而言,其假阳性率高达60％～70％,因此毫无价值。ST段标准的局限性和它的缺点,促使众多学者寻求新的标准。近几年来这方面的研究以冠状动脉造影结果为基本依据,能较客观地反映各种新标准的实际使用价值。本文综述评价心电图运动试验的新标准。 1 最大ST/HR斜率运动时心率的变化和相应的ST段偏移这两个变量同心肌缺血有关。用最大ST/HR斜率综合这两个变量可显著提高运动试验诊断冠心病的敏感性和特异
Since the Master’s first two-stage ladder electrocardiogram test in 1929, after long-term exploration and continuous improvement, the electrocardiogram exercise test has become the most important noninvasive diagnostic method for coronary heart disease and a good indicator to evaluate the therapeutic effect. The assessment of electrocardiogram exercise test has always been to ST segment offset as the standard, it is more reliable and generally valued, the sensitivity of 60% to 70%, specificity of 85% to 90%. However, some people think that as a normal population means of coronary heart disease screening, the false positive rate as high as 60% to 70%, so worthless. ST segment standard limitations and its shortcomings, prompting many scholars to find new standards. In recent years, this study based on the results of coronary angiography can more objectively reflect the actual value of various new standards. This article reviews the new criteria for evaluating electrocardiographic exercise testing. The changes in heart rate at 1 maximal ST / HR slope and corresponding ST segment deviations were associated with myocardial ischemia. Combining these two variables with maximum ST / HR slope can significantly increase the sensitivity and specificity of the exercise test in the diagnosis of CHD