平板运动负荷试验中室性心律失常与冠状动脉病变关系的研究

摘要

Objective To study the relationship between the occurrence of disease. Methods 166 cases received coronary artery angiography(CAG), in which ventricular arrhythmia occurred during the course of TET. Results According to the results of TET,166 cases were classified into five groups: accidental ventricular fibrillation (VF). The cases with 50% or more stenosis of coronary artery were definited as the positive. According to the stenostic position, the positive cases were classified into four groups: left main coronary artery(LM), left descending artery(LDA), circumflex (CX) and right coronary artery(RCA). The results showed: 92 cases were positive(of 166). 30 positive(of 66) in AVP group, 38 positive (of 67) in FV group,17 positive(of 26) in MCVP groug, 6 positive(of 6) in PVT group,1 positive(of 1) in VF group. The rates of PVT and VF were significantly in groups of LM and LDA with stenosis or severe stenosis (P＜0.05).Conclusions Ventricular arrhythmia could be stimulated during the course of TET. The risky degree of the occurrence of ventricular arrhythmia increased with the degree of stenosis of coronary artery and the amounts of diseased coronary arteries .It is most significant to guide the classification of the risky degree of coronary artery disease.%目的 探讨平板运动负荷试验时发生的室性心律失常与冠状动脉病变之间的关系.方法 对166例平板运动试验中出现的室性心律失常患者行冠状动脉造影术,分析冠脉病变及程度.结果 将平板运动试验结果 分为偶发室早、频发室早、多源成对室早、短阵室速、室颤5组.将冠状动脉造影狭窄≥50%定为冠造阳性.冠脉造影阳性分为左主干、左前降支、回旋支、右冠4组.结果 显示:166例冠脉造影中92例患者冠造阳性.66例偶发室早中30例冠造阳性;67例频发室早中38例冠造阳性;26例多源成对室早中17例冠造阳性;短阵室速6例和室颤1例冠造均为阳性.左主干、左前降支狭窄的程度越重的患者,短阵室速、室颤发生率明显增高(P＜0.01).结论 运动试验诱发室性心律失常的数量越多、级别越高,累及血管病变的程度越重,提示危险性越高,对冠心病的诊断及危险分层有较大的临床意义.