动态心电图与平板运动试验在冠心病诊断中的价值  

Clinical value of Holter electrocardiogram examination and plate exercise test for diagnose coronary heart disease

作　　者：张馥莉 郑林立 Zhang fuli;Zheng linli(Shantou City second People's Hospital,Shantou,515000,China)

机构地区：[1]汕头市第二人民医院,515000

出　　处：《临床心电学杂志》2024年第6期407-410,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨12导联动态心电图检查(12导联AECG,24小时动态监测)与平板运动试验(TET)在冠心病(CHD)中的诊断价值。方法选取2021年7月至2023年6月期间医院心血管内科收治的87例疑诊CHD患者,所有患者入院时均有胸痛、胸闷等症状,并完成TET检测、12导联AECG检测、CAG检测。以CAG检测结果为金标准,分析TET、12导联AECG两种检测方法的诊断效能。另根据患者病变支数进行分组,比较两种检测方法的检出率,分析病变支数对诊断准确度的影响。结果87例患者中,共64例患者确诊为CHD,占比73.56%。TET检测的敏感度为73.44%,特异度为82.61%;AECG检测的敏感度为64.06%,特异度为73.91%;联合检测的敏感度为81.25%,特异度为69.57%。64例CHD患者中,单支病变35例,多支病变29例。多支病变组TET、AECG、联合检测的检出率均高于单支病变组(P<0.05)。结论在CHD诊断中,TET与12导联AECG检查结果均有参考价值,但需警惕假阴性、假阳性风险,两者合用可提升诊断的敏感度。Objective To investigate the diagnostic value of 12-lead Holter electrocardiogram(12-lead AEECG,24h dynamic monitoring)and plate exercise test(TET)in coronary heart disease(CHD).Methods Eighty-seven suspected CHD patients admitted to the Department of Cardiovascular Medicine from July 2021 to June 2023.All patients had chest pain and chest tightness on admission,and completed TET test,12-lead AECG test and CAG test.The results of CAG test were used as the gold standard,and the diagnostic efficacy of TET and 12-lead AECG was analyzed.In addition,patients were grouped according to the number of lesion branches,compared the detection rate of the two detection methods,and the influence of lesion branches on the diagnostic accuracy was analyzed.Results Among the 87 patients,in total,64 patients were diagnosed with CHD,accounting for 73.56%.The sensitivity of TET was 73.44%and specificity 82.61%;the sensitivity of AECG was 64.06%and specificity 73.91%;the sensitivity was81.25%and specificity 69.57%.Of the 64 CHD patients,35 had single and 29 multibranch lesions.The detection rate of TET,AECG and combined test in multiple lesions were higher than that in single lesion group(P<0.05).Conclusions In the diagnosis of CHD,both TET and 12-lead AECG examination results have reference value,but the risk of false negative and false positive should be vigilant.The combination can improve the sensitivity of diagnosis.

关 键 词：冠心病 动态心电图 平板运动试验 诊断效能 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]