活动平板运动试验诱发缺血性T波对冠心病的诊断价值  

The diagnosis value on parameters of treadmill exercise test for coronary artery disease

作　　者：孙健玲[1] 郭继鸿[2] 许原[2] 李小鹰[3] 马彩云[1] 吴丽华[1] 刘彦伯[1] 刘倩[1] 

机构地区：[1]航空总医院心内科,北京100012 [2]北京大学人民医院心内科电生理室 [3]中国人民解放军总医院老年心内科

出　　处：《心电图杂志（电子版）》2014年第3期154-156,共3页Journal of Electrocardiogram（Electronic Edition）

基　　金：中航工业医疗课题基金(HKZYY2013008);北京市三甲医院联合课题(CVAH631ACN02;CXU0320ACN03;NIS-CCNCRE-2008/1)

摘　　要：目的总结平板运动试验诱发缺血性T波对冠心病的诊断价值。方法回顾性总结分析住院接受活动平板运动试验(TET)及冠状动脉造影(CAG)检查患者445例平板运动试验诱发缺血性T波对冠心病的诊断价值。结果 1445例中,TET阳性200例,其中CAG阳性150例,CAG阴性50例;TET阴性245例,其中CAG阴性206例,CAG阳性39例。TET检出冠心病的敏感性为79.36%(150/189),特异性为80.47%(206/256)。2T波正常化组和运动试验阳性组间冠状动脉造影阳性无统计学意义(P>0.05);运动试验阴性组与T波正常化组、运动试验阳性组冠状动脉造影阳性结果比较,有统计学意义(P<0.05)。结论平板运动试验诱发的缺血性T波(T波正常化)作为运动试验阳性的新指标。Objective To determine the diagnostic value of treadmill exercise test（TET）in patients with coronary heart disease （CHD）by comparing the diagnostic conclusion with coronary angiography（CAG）.Methods 445 patients with coronary heart disease（CHD）and suspected CHD underwent treadmill exercise test and coronary angiography （CAG）, and the diagnostic conclusions were compared. Results （!）The 200 cases had the positive result during treadmill exercise test and 150cases hand been diagnosed CHD by coronary angiography; The 245 cases had the negative result during treadmill exercise test and 39cases hand been diagnosed CHD by coronary angiography. The sensitivity, specificity, positive predictive value, negative predictive value, the false positive incidence, the false negative incidence and agreement rate in diagnosis of CHD by treadmill exercise test were 79.36%, 80.40%, 75.00% , 84.08%, 25.00%, 15.92% and 80.00%, respectively. The patients with muhi-vessel diseased had a higher positive rate of TET as compared with those with single diseased vessel（P〈0.05）. （~）chest leads positive rate was more than that of limb leads（P〈0.05）. （3）R wave amplitude after exercise to reduce with normal coronary artery. But, with significant stenosis of coronary, R wave amplitude after exercise to increase. （4） There were no statistically significant between T wave normalization group and TET positive group（P〉0.05）. But, there were statistically significant among TET negative group , T wave normalization group and TET positive group （P〈0.05）. Conclusions The treadmill exercise test is valuable in noninvasive diagnosis of CHD, especially for patients with muhi-vessel diseased. Ischemic T-wave＇ s changes in the comprehensive exercise testing can be initially estimated the severity, T wave normalization can be as a new positive indicators of exercise test.

关 键 词：活动平板运动试验 冠心病 冠状动脉造影 T波正常化 

分 类 号：R541.4[医药卫生—心血管疾病]