活动平板运动试验对诊断冠心病准确性的影响因素  

Influencing Factors in Treadmill Exercise Test Positive Results for the Diagnostic Accuracy of Coronary Heart Disease

作　　者：尹琳[1] 李波[1] 张麟[1] 王月[1] 张红珊[1] 纳志英[1] 

机构地区：[1]昆明医学院第二附属医院心功能科,云南昆明650101

出　　处：《昆明医学院学报》2012年第1期94-97,共4页Journal of Kunming Medical College

摘　　要：目的探讨活动平板运动试验阳性结果对诊断冠心病的准确性的影响因素,从而提高真阳性率.方法选择54例可疑冠心病且平板运动试验阳性患者,并在同期内行冠脉造影检查.根据冠脉造影结果将其分为真阳性组(A组)和假阳性组(B组),对比分析各项临床资料及平板运动试验数据.结果真阳性组和假阳性组在性别、最大运动耐量(Mets)、运动峰值心率、运动峰值收缩压及收缩压上升幅度方面有显著性差异(P<0.05,0.01).A组平板运动试验后1、2 min心率恢复显著低于B组(P<0.05),提示A组心脏变时功能较B组差;A组中运动诱发胸痛、ST段下降>0.2 mV及包含2个以上冠心病危险因子的例数明显大于B组(P<0.05);2组运动后心电图发生改变的主要导联有差异(P<0.05);2组年龄、ST段下降≤0.2 mV的例数以及包含2个以下冠心病危险因子的例数无明显差别.结论活动平板运动试验阳性结果结合相关的临床资料、典型胸痛症状及平板运动试验的各项参数,能提高冠心病的诊断特异性,对临床诊断冠心病、判断预后等方面提供有价值的参考.Objective To explore the influencing factors in treadmill exercise test positive results for the diagnostic accuracy of coronary heart disease, so as to improve the TPR （true positive rate）. Methods We selected 54 patients who has suspected coronary artery disease with positive treadmill exercise test, and administered Coronary Angiogram Examination at the same time. We classified the coronary angiography results into the true positive group （group A） and false positive group （group B） , then compared and analyzed the clinical data and treadmill exercise test data. Results True positive group and false positive group had difference in the aspects of sex, maximum exercise tolerance （Mets） , sports peak heart rate, peak systolic pressure and ascensional range of the pressure （P 〈 0.05, 0.01 ）. After treadmill exercise test , Group A：2 min heart rate recovery was significantly lower than group B （P 〈 0.05, 0.01） Note： The heart function of Group A was weaker than group B. In group A , sports evoked chest pain, ST segment down 〉 0.2 mV and contains two or more cases with coronary heart disease risk factors, which was significantly greater than group B （P 〈 0.05）. The main connection of ECG changes had differences between the two groups.There were no obvious differences in the number of cases between the two groups of age, ST segment down ~〈 0.2 mV, and less than 2 cases with coronary heart disease risk factors. Conclusion Clinical data, typical chest pain symptoms and various parameters in combination of the treadmill exercise testpositive results can improve the diagnosis specificity of coronary heart disease. It could also provide valuable reference to clinical diagnosis and prognosis of coronary heart disease.

关 键 词：活动平板运动试验 冠状血管造影术 冠心病 

分 类 号：R543.3[医药卫生—心血管疾病]