平板运动试验可疑阳性结果的临床意义  

The clinical significance of suspicious positive results of treadmill exercise tests

作　　者：吴依思 刘鸣[1] WU Yisi;LIU Ming(Department of Cardiology,Wuhan Asia Heart Hospital,Wuhan 430021,China)

机构地区：[1]武汉亚洲心脏病医院心功能科,武汉430021

出　　处：《中国研究型医院》2023年第4期40-44,共5页Chinese Research Hospitals

摘　　要：目的探讨平板运动试验(TET)可疑阳性结果对冠心病临床诊疗的指导意义。方法本研究为回顾性临床资料分析。按照纳入和排除标准,搜集2017年7月—2022年7月在我院454例拟诊为冠心病并行TET患者的病例资料,按照TET结果,分为阳性组(237例)和可疑阳性组(217例),分析两组年龄、性别、心肌桥、高血压、高血脂、高血糖和冠脉狭窄程度等方面的差异,其中两组年龄比较采用两独立样本非参数检验(Mann-Whitney检验),性别、心肌桥、高血压、高血脂、高血糖和冠脉狭窄程度的比较则采用χ^(2)检验。结果两组患者性别占比:阳性组男性占60.8%(138/227)、女性占39.2%(89/227),可疑阳性组男性36.0%(78/217)、女性64.0%(139/217),两组差异有统计学意义(P<0.05)。阳性组22.0%(50/227)无冠脉狭窄、37.0%(84/227)冠脉狭窄1%~49%、41.0%(93/227)冠脉狭窄≥50%,可疑阳性组无冠脉狭窄者占40.6%(88/217)、冠脉狭窄1%~49%和≥50%者分别占39.6%(86/217)和19.8%(43/217),两组相比差异均有统计学意义(P均<0.05)。排除性别影响,阳性组无冠脉狭窄者、冠脉狭窄1%~49%和≥50%者分别占18.1%(25/138)、34.8%(48/138)和47.1%(65/138),可疑阳性组分别为28.2%(22/78)、42.3%(33/78)和29.5%(23/138),两组男性患者在冠脉狭窄程度上差异仍有统计学意义(P<0.05)。两组患者心肌桥、高血压、高血脂和高血糖病史占比差异无统计学差异(P均>0.05)。结论当患者TET结果为可疑阳性时,尤其是男性患者,也和阳性结果一样对临床诊疗冠心病具有指导意义;不同的是,可疑阳性结果反映出来的冠脉狭窄程度更轻。Objective To explore the guiding significance of suspicious positive results in treadmill exercise test(TET)for the clinical diagnosis and treatment of coronary heart disease.Methods This study is a retrospective analysis of clinical data.Patients who were diagnosed with coronary heart disease and underwent a treadmill exercise test in our hospital from July 2017 to July 2022 were selected(454 cases)and divided into two groups:the positive group(237 cases)and the suspicious positive group(217 cases).The differences between the two groups were analyzed in terms of age,gender,myocardial bridge,hypertension,hyperlipidemia,hyperglycemia,and degree of coronary stenosis.The comparison of age was conducted using the Mann-Whitney test,a nonparametric test for independent samples,while the comparison of gender,myocardial bridge,hypertension,hyperlipidemia,hyperglycemia,and degree of coronary stenosis was performed using theχ^(2) test.Results In the positive result group,males accounted for 60.8%(138/227)and females accounted for 39.2%(89/227),while in the suspicious positive result group,males accounted for 36.0%(78/217)and females accounted for 64.0%(139/217).The difference in gender distribution between the two groups was statistically significant(all P<0.05).Among the positive result group,22.0%(50/227)had no coronary stenosis,37.0%(84/227)had coronary stenosis of 1%to 49%,and 41.0%(93/227)had coronary stenosis of 50%or more.In the suspicious positive result group,40.6%(88/217)had no coronary stenosis,39.6%(86/217)had coronary stenosis of 1%to 49%,and 19.8%(43/217)had coronary stenosis of 50%or more.The differences between the two groups were statistically significant in both cases(all P<0.05).After excluding the influence of gender,in the positive result group,18.1%(25/138)had no coronary stenosis,34.8%(48/138)had coronary stenosis of 1%to 49%,and 47.1%(65/138)had coronary stenosis of 50%or more.In the suspicious positive result group,the respective percentages were 28.2%(22/78),42.3%(33/78),and 29.5%(23/138).The dif

关 键 词：诊断技术 心血管 心电描记术 运动试验 冠心病 可疑阳性 

分 类 号：R541.4[医药卫生—心血管疾病]