活动平板运动试验在隐匿性冠心病中的应用研究  

Application of Treadmill Exercise Test in Occult Coronary Heart Disease

作　　者：郑云平 简艳红 李根林 ZHENG Yunping;JIAN Yanhong;LI Genlin(Department of Electrophysiology,Xinyu People's Hospital,Xinyu 338000,China;不详)

机构地区：[1]新余市人民医院电生理诊断科,江西新余338000 [2]新余市人民医院心血管内科,江西新余338000

出　　处：《中国医学创新》2025年第2期144-147,共4页Medical Innovation of China

基　　金：新余市科技计划项目(20233090880)。

摘　　要：目的:探讨活动平板运动试验对隐匿性冠心病的诊断价值。方法:选取2022年1月—2023年10月新余市人民医院收治的81例疑似隐匿性冠心病患者,行活动平板运动试验,以冠状动脉造影(coronary angiography,CAG)结果为金标准进行对比,分析活动平板运动试验对隐匿性冠心病的诊断价值。结果:81例高度疑似隐匿性冠心病患者中,CAG诊断阳性患者71例,其中轻度狭窄占比26.76%,中度狭窄占比49.30%,重度狭窄占比23.94%。CAG阳性组最大运动耐量、运动峰值心率、运动峰值收缩压(SBP)、活动平板运动试验运动中峰值心率与运动试验结束后1 min、2 min恢复期心率的差值(ΔHR1、ΔHR2)均低于CAG阴性组(P<0.05)。活动平板运动试验诊断阳性65例,与CAG诊断结果的一致性较高(Kappa=0.611)。以CAG诊断结果为金标准,活动平板运动试验诊断隐匿性冠心病的敏感度为91.55%,特异度为80.00%,诊断准确率为90.12%,阳性预测值为97.01%,阴性预测值为57.14%。结论:活动平板运动试验可有效诊断隐匿性冠心病,且与CAG诊断结果的一致性较高,或许可替代CAG检查作为疑似隐匿性冠心病的首选筛查方法。Objective:To investigate the diagnostic value of treadmill exercise test in occult coronary heart disease.Method:Eighty-one patients who were highly suspected of occult coronary heart disease and admitted to Xinyu People's Hospital from January 2022 to October 2023 were selected.Treadmill exercise test were performed.With coronary angiography(CAG)results as the gold standard,the value of treadmill exercise test in diagnosing occult coronary heart disease and the detection of different degrees of coronary artery stenosis was compared.Result:Among 81 patients enrolled,71 patients were diagnosed with occult coronary heart disease by CAG.The proportions of patients with mild stenosis,moderate stenosis,and severe stenosis were 26.76%,49.30%,and 23.94%,respectively.The maximum exercise tolerance,peak exercise heart rate,peak systolic blood pressure(SBP),and the difference between peak heart rate during treadmill exercise test exercise and recovery heart rate at 1 minute and 2 minutes after exercise test(ΔHR1,ΔHR2)in CAG positive group were significantly lower than those in CAG negative group(P<0.05).65 patients were diagnosed with occult coronary heart disease by treadmill exercise test,indicating high consistency with the diagnostic results of CAG(Kappa=0.611).Using CAG as the gold standard,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value were 91.55%,80.00%,90.12%,97.01%,and 57.14%respectively.Conclusion:Treadmill exercise test can effectively diagnose occult coronary heart disease,and the consistency with CAG diagnosis is high,which may replace CAG test as the first choice screening method for suspected occult coronary heart disease.

关 键 词：隐匿性冠心病 活动平板运动试验 诊断价值 敏感度 特异度 诊断准确率 

分 类 号：R541.4[医药卫生—心血管疾病]