• 作者： 丁予安; 謝士明; 鄭澄意; 王丹江; 宋丕錕
• 作者服務機構： 三軍總醫院心臟內科及核子醫學部
• 中文摘要： 在一系列168位年齡由41至57歲（平均53歲）無症狀的中國男性健康檢查中，最大履帶式運動心電圖的效用再次被評估。於靜態心電圖中，沒有一位有不正常的Q波。當到達年齡預估最大心率時的運動心電圖實驗終點時，沒有人曾於實驗中或實驗後出現典型的心絞痛。35位受測者出現可逆的水平性或下斜性的S-T段下降大於或等於 1.0 毫米，持續等於或超過0.08秒。鉈201肌攝影（Exercise Thallium 201 myocardial image），其中有30位（百分之八十六）顯示完全正常，僅5位出現不正常的影像。16位鉈201心肌攝影正常的受測者再接受冠狀動脈攝影檢查，14位顯示完全正常，僅2位在一條重要血管中出現小於百分之四十九內徑寬度的狹窄。而在5位有不正常鉈201心肌攝影的受測者中，4位發現至少有一條以上的主要動脈出現了百分之五十或以上的內徑狹窄，而另一位也有小於百分之四十九的內徑狹窄。我們的結論是單以履帶式運動心電圖來診斷重要的冠狀動脈疾病，對無症狀的患者僅能提供有限的效用，特別是在冠狀動脈疾病流行率較低的地區。
• 英文摘要： The value of maximal treadmill exercise electrocardiogram (TEE) in predicting coronary arterydisease was evaluated in a consecutive series of 168 asymptomatic Chinese males, aged 41 to 57 years(mean 53) during annual physical examinations. Their resting electrocardiograms (ECGs) showed noabnormal Q-waves. The end-point of TEE achieved the age-predicted maximal heart rate, and no subjectshad classic angina pectoris during or after TEE. Thirty-five subjects had positive electrocardiographicchanges defined as reversible horizontal or downsloping ST-segment depression ≧ 1.0 my which lasted≧0.08 sec. Exercise thallium - 201 (T1-201) myocardial imaging was performed on all 35 subjects withpositive TEE; 30 subjects (86%) demonstrated normal and 5 abnormal scintigrams. Sixteen of the 30cases with normal T1-201 scans underwent coronary arteriography, of which 14 showed normal arterio-grams and two showed a ＜ 49% stenosis of the luminal diameter in one major artery. Of the 5 cases withabnormal scintigrams, 4 were found to have ＞ 50% stenoses in at least one major artery, and only onecase had a ＜ 49% stenosis of the right coronary artery. We concluded that TEE alone for asymptomaticindividuals provided limited value in diagnosing significant coronary artery disease, especially in areas oflow prevalence.
• 中文關鍵字： coronary artery disease; treadmill exercise electrocardiogram; thallium 201 myocardial scintigram
• 英文關鍵字： --