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[心肌梗死后无胸痛的运动试验阳性的价值]

[Value of the positive exercise test without angina (after myocardial infarct)].

作者信息

Saint-Pierre A, Gare J P, Monnet M F, Veillas G, Durand de Gevigney G, Zambartas C, Delahaye J P

机构信息

Hôpital cardio-vasculaire et pneumologique Louis-Pradel, Lyon.

出版信息

Arch Mal Coeur Vaiss. 1989 Oct;82(10):1701-7.

PMID:2512872
Abstract

In order to determine the value of a positive exercise test (ET) (i.e. ischaemic ST depression) without chest pain observed after a myocardial infarction (MI), 102 ET's were reviewed. ET was performed without anti-ischaemic drugs. The mean time-lag between MI and ET was 51 +/- 55 months. The MI was inferior in 26 cases, inferior and/or posterior in 74 cases and of undetermined location in 2 cases. Thirty patients had both ST depression and chest pain (group 1); 35 had electrocardiographic signs of ischaemia without pain (group 2), and 37 had neither chest pain nor signs of ischaemia (group 3). Age, sex ratio, site of infarction and time-lag between MI and ET were similar in all three groups. The post-ET follow-up period was 33 +/- 18 months (range: 6 to 66 months); 2 patients in group 3 were lost sight of. There was no significant difference between groups 1 and 2 as regards total duration of ET, workload attained, heart rate, systolic arterial pressure, pressure-rate product and amplitude of ST depression at maximum exercise level. Group 3 differed from the other 2 groups in workload attained (p less than 0.05) and in pressure-rate product (p less than 0.05 vs group 1, p less than 0.01 vs group 2). There was no significant difference between groups 1 and 2 as regards post-ET events (recurrent angina, reinfarction, coronary bypass, transluminal angioplasty).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为了确定心肌梗死(MI)后出现的无胸痛的阳性运动试验(ET)(即缺血性ST段压低)的价值,我们回顾了102例运动试验。运动试验在未使用抗缺血药物的情况下进行。心肌梗死与运动试验之间的平均时间间隔为51±55个月。26例心肌梗死为下壁,74例为下壁和/或后壁,2例梗死部位不明。30例患者既有ST段压低又有胸痛(第1组);35例有心电图缺血征象但无胸痛(第2组),37例既无胸痛也无缺血征象(第3组)。三组患者的年龄、性别比例、梗死部位以及心肌梗死与运动试验之间的时间间隔相似。运动试验后的随访期为33±18个月(范围:6至66个月);第3组有2例失访。第1组和第2组在运动试验总时长、达到的工作量、心率、收缩压、压力-心率乘积以及最大运动水平时的ST段压低幅度方面无显著差异。第3组在达到的工作量方面与其他两组不同(p<0.05),在压力-心率乘积方面也不同(与第1组相比p<0.05,与第2组相比p<0.01)。第1组和第2组在运动试验后事件(复发性心绞痛、再梗死、冠状动脉搭桥术、经皮腔内血管成形术)方面无显著差异。(摘要截断于250字)

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