运动平板试验中ST指标结合CRI值诊断冠心病的价值  

Clinical significance of the index ST and CRI during treadmill test in the diagnosis of coronary heart disease

作　　者：雷蕾[1] 王红艺[1] 吴炳云[1] 

机构地区：[1]山东省千佛山医院,山东济南250014

出　　处：《山东医药》2008年第29期12-13,共2页Shandong Medical Journal

摘　　要：目的探讨运动平板试验中ST指标结合CR I值诊断冠心病(CHD)的价值。方法对598例拟诊CHD患者(男309例,女289例)分别行运动平板试验(TET)和冠状动脉造影(CAG)检查,根据CAG结果对比ST指标及其结合心率变时性反应指数(CR I)诊断CHD的敏感性、特异性、阴性预测值、阳性预测值。结果①运动平板试验中,ST指标阳性诊断男性CHD敏感性为96.10%,特异性为46.15%,阳性预测值为7.87%,阴性预测值为85.71%;结合CR I<0.8分别为98.01%、52.17%、81.74%、92.31%。②ST指标阳性诊断女性CHD敏感性为84.68%,特异性为57.32%,阳性预测值为59.66%,阴性预测值为83.19%;结合CR I<0.8分别为92.92%、80.34%、82.03%、92.16%。结论TET中ST指标阳性结合CR I<0.8可提高诊断女性CHD的特异性(P<0.01);降低男、女CHD的假阴性率(P<0.05)。Objective To investigate the clinical significance of the index ST and CRI during treadmill test in the diagnosis of coronary heart disease. Methods 598 patients who were to be diagnosed the CHD received treadmill test and CAG examination. The sensitivity and specificity, positive and negative predictive value of the index ST were compared with that of the index ST combined CRI. Results ①The sensitivity and specificity,positive and negative predictive value of index ST（ ＋ ） in diagnosing male CHD were 96.10% ,46.15% ,7.87% ,85.71%. Those of index ST combined CRI 〈0. g were 98.01% ,52. 17 %, 81.74% ,92.31%. ②The sensitivity and specificity, positive and negative predictive value of index ST（ ＋ ） in diagnosing female CHD were 84.68% ,57.32% ,59.66% ,83.19%. Those of the index ST combined CRI 〈0.8 were 92.92% ,80.34% ,82.03% ,92.16%. ③The negative predictive value of excluding CHD using the ST index （ - ） was 85.71% （male） and 83.19% （female）. ④The negative predictive value of the index ST（-） combined CRI 〈 0.8 was 92.31% （male） and 92.16% （female）. Conclusions ①The index ST （ ＋ ） combined CRI 〈 0. 8 can increase the sensitivity of diagnosis in female CHD. ②The index ST（ - ） combined CRI 〈 0.8 can increase the specifity both in male and female CHD,while decrease the false negative rate.

关 键 词：运动平板试验 冠心病 心率变时性反应指数 

分 类 号：R541.4[医药卫生—心血管疾病]