心绞痛患者冠脉造影与TET结果对比研究  

Misdiagnostic factors related treadmill electrocardiogram test for the detection of coronary heart disease:coronary angiography compardtive study

作　　者：苏启燕[1] 李琳[1] 周荣[1] 

机构地区：[1]山东省立医院,山东济南250021

出　　处：《医学影像学杂志》2005年第5期398-400,共3页Journal of Medical Imaging

摘　　要：目的:以冠状动脉造影为依据与心电图运动试验(TET)比较,探讨TET的假阳性因素。方法:对270例胸痛患者进行TET和冠状动脉造影(CAG)检查,收集病史及辅助检查资料。对比TET和CAG的结果,计算TET的敏感性、特异性和准确性;对比TET真阳性组和假阳性组的各项临床资料特点并进行统计学分析。结果:本组病例TET诊断冠心病的敏感性为76.3%,特异性为65.5%,准确性为69.6%;假阳性组女性患者例数较多;具有典型胸痛症状、高脂血症、吸烟史、饮酒史、冠心病家族史的例数较少;运动中ST段的下降多发生于Ⅱ、Ⅲ、aVF导联,ST段下降>0.2mV以及运动中出现心绞痛的例数较少,两组差别有统计学意义。结论:性别、典型缺血性胸痛症状、冠心病的某些危险因素、运动后心电图发生变化的部位和程度、运动中胸痛症状的出现,是造成TET假阳性结果的误诊因素。Objective:To investigate the misdiagnostic factors related to false positive results of electrocardiogram treadmill exercise test (TET) for the detection of coronary heart disease (CHD).Methods:270 patients with chest pain undergoing TET and coronary angiography (CAG) were onrolled. The case history and various clinical parameters were collected.The results of TET and CAG were compared to evaluate the sensitivity, specificity and accuracy of TET;Clinical informations of the true positive group and the false positive group were compared and a statistic analysis was carried out.Results:The sensitivity, specificity and accuracy of TET for diagnosing CHD was 76.3%, 65.5%, and 69.6% respectively. The number of female in the false positive group was larger than that in the true positive group; The number of patients with typical chest pain, hyperlipidemia, smoking or drinking history and family history of CHD was smaller than that in the true positive group. In the false positive group, the decline of ST segment was mainly in Ⅱ?Ⅲ?aVF. The number of patients with change of more than 0.2mV in ST and with angina induced during exertion was lower in the false positive group than in the true positive group. The difference was significant.Conclusion:Sex, typical chest pain,certain risk factors of CHD, the location and extent of ECG changes and angina induced by exertion are possible misdiagnostic factors leading to false positive results of TET.

关 键 词：运动试验 冠状血管造影术 冠状动脉疾病 

分 类 号：R541[医药卫生—心血管疾病] R815[医药卫生—内科学]