平板运动试验和潘生丁负荷试验对冠心病的诊断价值研究  

The value of treadmill exercise test and dipyridamole electrocardiography stress test in diagnosis of coronary heart disease

作　　者：张黎军[1] 谢青[2] 何勇[1] 李庚山[3] 江洪[3] 

机构地区：[1]武汉大学人民医院老年病科,武汉430060 [2]上海第二医科大学瑞金医院康复医学科 [3]武汉大学人民医院心内科

出　　处：《中华物理医学与康复杂志》2003年第10期595-598,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的　探讨潘生丁心电图负荷试验在冠心病诊断中的价值 ,旨在为不能耐受运动试验的特殊人群提供安全有效、简便易行的冠心病辅助诊断方法。方法　共选取临床疑似或确诊的男性冠心病住院患者5 2例 ,年龄 41～ 75岁 ,在 1个月内先后进行平板运动试验、潘生丁负荷试验及冠状动脉造影检查并分析比较结果。结果　①平板运动试验和潘生丁负荷试验诊断冠心病的敏感性、特异性分别为 10 0 %、78.95 %和79 .3 1%、65 .2 2 %。②当患者冠状动脉病变支数分别为 0、1、2、3支时 ,平板运动试验与潘生丁负荷试验的阳性例数则分别为 0、2、10、17例和 0、6、10、15例。③在潘生丁负荷试验中 ,分别将患者的症状、心电图改变及两者相结合作为冠心病阳性诊断标准 ,其敏感性、特异性则分别为 72 .41%、65 .2 2 % ;65 .5 2 %、82 .61% ;及 79.3 1%、65 .2 2 %。结论　潘生丁负荷试验与平板运动试验诊断冠心病的敏感性及特异性基本相同 ;随着患者冠状动脉病变支数的增多、病情的加重 ,上述两项负荷试验的阳性例数也相应增加 ;Objective To investigate the value of treadmill exercise test and dipyridamole electrocardiography stress test (DP T) in diagnosis of coronary heart diseases (CHD), with an attemp of developing a safe, effective and simple diagnostic method for patients intolerable to the exercise. Methods Fifty two male patients aged from 41 to 75 years, averaged 58.44±8.79 years and with suspected or confirmed CHD were recruited to perform the treadmill exercise test, DP T and coronary angiography, respectively, within one month. Results The sensitivity and specificity of the treadmill exercise test for diagnosing CHD were 100% and 78.95%, respectively, while those of DP T for diagnosing CHD were 79.31% and 65.22%, respectively.As corresponded to the number of sites of coronary artery lesions,the numbers of cases with positive results revealed were 0, 2, 10 and 17 by the treadmill exercise tests and 0, 6, 11 and 15 by DP T, respectively.Based on the criteria of DP T, the sensitivity and specificity symptom, the changes in electrocardiography (ECG) and the combination of the two, for diagnosing CHD were 72.41%, 65.22%; 65.52%, 82.61%;and 79.31%, 65.22%, respectively. Conclusion The sensitivity and specificity of the treadmill exercise test and the DP T in the diagnosis of CHD were similar. More positive cases were revealed in above mentioned tests as the sites and degree of coronary artery lesion increased. DP T was particularly suitable for helping diagnose CHD in patients intolerable to exercise.

关 键 词：平板运动试验 潘生丁负荷试验 冠心病 诊断 研究 

分 类 号：R541.4[医药卫生—心血管疾病]