运动平板试验对CohnⅠ型无症状心肌缺血的诊断价值  

Study on Treadmill Exercise ECG Testing in the Diagnosis of Cohn Ⅰ Slient Myocardial Ischemia

作　　者：张存新[1] 李孝华[1] 张丽君[1] 陈嵘[1] 

机构地区：[1]武警新疆总队医院高血压科,乌鲁木齐830091

出　　处：《解放军医药杂志》2012年第7期14-17,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的评价运动平板试验(treadmill exercise ECG testing,TET)对CohnⅠ型无症状心肌缺血(slient myo-cardial ischemia,SMI)的诊断价值。方法对经动态心电图检查拟诊的145例CohnⅠ型SMI进行TET及冠状动脉造影(CAG)检查,观察敏感性、特异性、准确性、阳性及阴性预测值。结果 TET诊断CohnⅠ型SMI的敏感性为89.3%,特异性为67.2%,准确性为80.0%,阳性预测值为78.9%,阴性预测值为82.0%;多支冠状动脉病变TET阳性率与单支病变比较差异无统计学意义(P>0.05)。合并有≥2个危险因素组TET检查敏感性和准确性均高于无/1个危险因素组,差异有统计学意义(P<0.01)。女性TET假阳性率高于男性,差异有统计学意义(P<0.01)。结论 TET对CohnⅠ型SMI的特异性较低,但敏感性较高,与SMI的危险因素相结合,能明显提高诊断的准确性,降低假阳性率。Objective To evaluate the value of treadmill exercise ECG testing in diagnosing cohn I silent myocardial ischemia（SMI）.Methods The sensitivity,specificity,accuracy rate,positive and negative predictive value of treadmill exercise ECG testing were compared with those of coronary angiography in 145 patients.Results The sensitivity,specificity and accuracy rate,positive and negative predictive value of treadmill exercise ECG testing in diagnosing SMI of Cohn I were 89.3%,67.2%,80.0%,78.9% and 82.0% respectively.In the patients with two or more silent myocardial ischemia′s hazard factors,treadmill exercise ECG testing showed a higher positive rate than the patients with few hazard factors.The diffierences were statistically significant（P〈0.01）.The positive rate in patients with multivessel disease was no higher than that in patients with single vessel disease（P〉0.05）.The false positive rate in female patients was higher than that in the male（P〈0.01）.Conclusion The treadmill exercise ECG testing has a lower specificity for the diagnosis of Cohn I silent myocardial ischemia,but a higher sensitivity.Combined with silent myocardial ischemia′s hazard factors,the treadmill exercise ECG testing can enhance the rate of diagnostic accuracy obviously and reduce the false positive rate.

关 键 词：心肌缺血 运动试验 冠状血管造影术 诊断 

分 类 号：R541.4[医药卫生—心血管疾病] R44[医药卫生—内科学]