平板运动试验不同指标对冠心病的诊断价值  

The value of different parameters in treadmill exercise test on diagnosis of coronary heart disease

作　　者：郭冰丽[1] 张树龙[2] 高森[3] GUO Bingli;ZHANG Shulong;GAO Sen(Department of Electrocardiogram,the First Affiliated Hospital of Dalian Medical University,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院心电图室,辽宁大连116011 [2]大连大学附属中山医院心脏中心,辽宁大连116001 [3]大连医科大学附属第一医院药学部,辽宁大连116011

出　　处：《实用医学杂志》2018年第18期3114-3117,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金资助项目(编号:81370307)

摘　　要：目的研究平板运动试验(TET)不同指标对冠心病的诊断价值。方法 435例疑诊为冠心病(CHD)的患者经冠状动脉造影(CAG)检查分为CHD组和非CHD组,计算ST段压低、微伏级T波电交替(MTWA)、ST/HR斜率、ST/HR指数及ST/HR滞后的灵敏度与特异度。用ROC曲线下面积评价5种指标的准确性。结果 ST/HR滞后灵敏度最高(92.1%),ST/HR斜率特异度最高(83.2%);ROC曲线下面积分析:ST/HR斜率(AUC:0.837,P <0.001)、ST/HR指数(AUC:0.738,P <0.001)与ST/HR滞后(AUC:0.703,P <0.001)的准确性均高于传统的ST段压低标准(AUC:0.679,P <0.001)。结论 ST/HR斜率、ST/HR指数与ST/HR滞后提高了TET诊断CHD的准确性。Objective The aim of this study was to determine the value of different parameters of treadmill exercise test(TET)for diagnosis of coronary heart disease(CHD).Methods A total of 435 patients diagnosed with CHD were divided into CHD and non CHD groups according to the results of coronary angiography(CAG).The sensitivity and specificity of the ST segment,microvolt T-wave alternants(MTWA),ST/HR slop,ST/HR index and ST/HR loop for reaching the same diagnosis were evaluated afterwards.Area under the curve(AUC)analysis was used for comparison of the five measurements.Results The sensitivity of ST/HR loop was highest of the five parameters.The specificity of ST/HR loop was higher than that of other parameters.The ST/HR slop,ST/HR index and ST/HR loop were more accurate measurements for the diagnosis of CHD than ST segment.Conclusion ST/HR slop,ST/HR index and ST/HR loop improved the value of diagnosis for CHD with TET.

关 键 词：冠心病 平板运动试验 ST/HR斜率 ST/HR指数 ST/HR滞后 

分 类 号：R541.4[医药卫生—心血管疾病]