平板运动试验结合动态心电图对冠心病的诊断价值  

Diagnostic value of treadmill exercise test combined with 24h dynamic electrocardiogram in patients with coronary heart disease

作　　者：彭钰[1] 孙步高[1] 张克宁[1] 周蓉[1] 张苏明[1] 

机构地区：[1]南京市鼓楼医院心功能室,江苏南京市210008

出　　处：《心血管康复医学杂志》2009年第3期293-295,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:以冠状动脉造影(CAG)结果作为标准,探讨平板运动试验(TET)结合24 h动态心电图(DCG)对冠心病(CHD)的诊断价值。方法:对236例患者行CAG,且同时行TET及DCG检查,分析TET及DCG两种检查方法各自对CHD的诊断价值,以及两者联合时对CHD的诊断价值。结果:TET诊断CHD的敏感性79.11%,特异性69.23%;DCG诊断CHD的敏感性67.72%,特异性80.77%;两者联合行并联试验时敏感性96.83%,特异性53.84%,阳性预测值80.95%,阴性预测值89.36%,敏感性、阴性预测值较单独TET、DCG试验有显著提高(P<0.05);两者联合行串联试验时敏感性50.00%,特异性96.15%,阳性预测值96.34%,阴性预测值48.70%,特异性、阳性预测值较单独TET、DCG试验有显著提高(P<0.05)。结论:单独行TET或DCG对冠心病诊断的敏感性和特异性相对较低,两者联合诊断可明显提高上述两项指标。Objective： To study the diagnostic value of treadmill exercise test （TET） combined with 24h dynamic electrocardiogram （DCG） in patients with coronary heart disease （CHD）. Methods： The results of coronary angiography （CAG） regard as the standard diagnosing CHD, compared the diagnostic value of TET combined with DCG and TET or DCG alone in 236 patients performed TET, DCG and CAG. Results： The Sensitivity rate was 79.11% and specific rate was 69.23% by the means of TET. The sensitivity rate was 67.72% and specific rate was 80.77% by the means of DCG. The sensitivity rate was 96.83%, specific rate was 53.84%, positive predictive value was 80.95% and negative predictive value was 89.36% by parallel way of DCG and TET, its sensitivity rate （96. 83%） negative predictive value （89.36%） were more than those of DCG or TET alone （P〈0.05）. The sensitivity rate was 50.00%, specific rate was 96.15%, positive predictive value was 96.34%and negative predictive value was 48. 70% by serial way of DCG and TET, its specific rate （96.15%）, positive predictive value （96. 34%） were more than those of DCG or TET alone （P〈0.05）. Conclusion： The sensitivity rate and specific rate are relatively low to diagnose CHD by TET or DCG, It can obviously enhance the sensitivity rate and specific rate if combined the TET and DCG.

关 键 词：运动试验 心电描记术 冠状血管造影 诊断 

分 类 号：R541.7[医药卫生—心血管疾病] R541.4[医药卫生—内科学]