运动平板与动态心电图在2型糖尿病冠状动脉病变诊断中应用对比  

Diagnosis application contrast of athletic flat and dynamic ECG in type 2 diabetes coronary artery disease

作　　者：王丹辉[1] 

机构地区：[1]空军航空医学研究所附属医院,100089

出　　处：《内蒙古中医药》2013年第2期64-65,共2页Inner Mongolia Journal of Traditional Chinese Medicine

摘　　要：目的:探讨运动平板与动态心电图在2型糖尿病冠状动脉病变临床诊断中应用价值。方法:我院于2009年2月～2011年2月分别采用运动平板和动态心电图对2型糖尿病患者进行临床检查,并探讨这两种检查方法在2型糖尿病冠状动脉病变临床诊断中应用价值。结果:本组141例2型糖尿病患者经"金标准"冠状动脉造影检查后发现其中有87例患者的主冠脉内径狭窄大于或者等于50%。这表明本组141例2型糖尿病患者中共有87例患者发生冠状动脉病变。运动平板试验诊断2型糖尿病冠状动脉病变的敏感性为72.41%(63/87),特异性为66.67%(36/54),阳性预测值为77.78%(63/81),阴性预测值为60.00%(36/60),预测准确性为70.21%(99/141)。运动平板对2型糖尿病冠状动脉病变的诊断敏感性明显高于动态心电图,差异具有统计学意义(X2=3.95,P<0.05)。结论:虽然运动平板试验的灵敏性明显优于动态心电图,但是运动平板对于2型糖尿病患者冠状动脉病变患者的诊断仍然存在一定的假阳性和假阴性比例,且存在一些禁忌,所以运动平板与动态心电图两种检查方法应联合使用,互补不足,以提高对2型糖尿病患者冠状动脉病变的临床诊断可靠性。Objective： To investigate the dynamic electrocardiogram and treadmill exercise in type 2 diabetes mellitus coronary artery disease clinical diagnosis value.Methods： in our hospital in 2009 February -2011 year in February respectively using the treadmill exercise and dy- namic electrocardiogram in patients with type 2 diabetes were clinically examined, and discuss the two methods of examination in type 2 dia- betes meUitus coronary artery disease clinical diagnosis value.Results： 141 cases of patients with type 2 diabetes by the ＂gold standard＂ of coronary angiography after inspection found that there are 87 main coronary artery stennsis patients with inner diameter greater than or equal to 50%.This shows that the group of 141 patients with type 2 diabetes mellitus in a total of 87 cases occurred in patients with coronary artery disease.TreadmiU exercise test in the diagnosis of type 2 diabetes mellitus coronary artery lesions of the sensitivity of 72.41% （63/87）, a speci- ficity of 66.67% （36/54）, the positive predictive value of 77.78% （63/81）, the negative predictive value was 60% （36/60）, prediction accuracy was 70.21% （99/141）.Treadmill exercise on type 2 diabetes mellitus coronary artery lesions diagnostic sensitivity was significantly higher than that of dynamic electrocardiogram, the difference was statistically significant （X2=3.95, P＆lt;0.05）.Conclusion： Although treadmiU exercise test sensitivity was significantly better than that of dynamic electrocardiogram treadmill exercise, but for patients with type 2 diabetes patients with coronary artery disease diagnosis still exist certain false positive and false negative rate, and there are some taboos, so the plate movement and dynamic electrocardiogram in two methods should be combined to use, to complement each other, in order to improve on the 2 diabetic pa- tients with coronary artery disease clinical diagnosis reliability.

关 键 词：运动平板 动态心电图 2型糖尿病 冠状动脉病变 

分 类 号：R540.41[医药卫生—心血管疾病]