平板运动试验对冠心病的诊断作用  

The diagnostic value of treadmill exercise test for coronary artery disease

作　　者：张宏宇[1] 葛华[2] 何志翔[1] 肖洪万[1] 

机构地区：[1]沈阳医学院奉天医院电诊科,辽宁沈阳110024 [2]沈阳医学院奉天医院心内科,辽宁沈阳110024

出　　处：《中国医药导报》2008年第13期36-37,共2页China Medical Herald

摘　　要：目的:通过平板运动试验与冠状动脉造影的对比分析,评价平板运动试验诊断冠心病的作用。方法:选择疑诊冠心病患者86例,行平板运动试验和冠状动脉造影检查,对比分析两种检查结果。结果:冠状动脉造影阳性35例中,运动试验阳性23例(真阳性),阴性12例(假阴性)。冠状动脉造影阴性51例中,运动试验阳性14例(假阳性),阴性37例(真阴性)。平板运动试验诊断冠心病的敏感性为65.7%,特异性为72.5%,准确性为69.8%。平板运动试验强阳性诊断冠心病的阳性预测值为81.3%。往往在低运动量时出现阳性改变者真阳性率高;运动量不足易出现假阴性结果。结论:行平板运动试验检查时,应综合分析患者运动量的高低、ST段改变的形式和程度等,以提高其诊断冠心病的准确性。Objective：To evaluate the value of treadmill exercise test （TET） for diagnosing coronary artery disease（CAD） by comparative analysis of treadmill exercise test and coronary angiography（CAC）.Methods： 86 patients suspected for CAD who underwent examinations of both TET and CAG were analyzed.Results：Significant CAD was detected by angiography in 35 patients,23 of these had true positive exercise testing results, and 12 had false negative results. No significant CAD was detected in the remaining 51 patients, and among these 37 had true negative exercise testing results, and 14 had false positive results. Sensitivity of TET in diagnosing CAD was 65.7%, specificity was 72.5%, and accuracy was 69.8%. There was a 81.3% positive predictive value in patients with strongly positive TET. There was always a high true-positive rate in those patients who underwent a low exercise load, and a high false-negative rate in those patients whose exercise load was not enough. Conclusion： These results suggest that, to improve the accuracy of treadmill exercise testing for diagnosing CAD, some factors such as exercise load, the degree of ST depression or elevation and the shape of ST segment, should be analyzed carefully.

关 键 词：平板运动试验 冠状动脉造影 冠心病 

分 类 号：R541[医药卫生—心血管疾病]