平板运动试验阴性患者最大ST/HR斜率对冠心病的诊断价值  

Value of maximal segment/heart rate slope of negative patient during tabular exercise test in diagnosing coronary artery disease

作　　者：林晓明[1] 

机构地区：[1]广东省佛山市第一人民医院心内科,528000

出　　处：《中国全科医学》2004年第4期238-239,共2页Chinese General Practice

摘　　要：目的　探讨平板运动试验阴性患者最大ST/HR斜率对冠心病的诊断价值。方法　选择 12 2例平板运动试验阴性而临床有明显冠心病指征的患者进行冠状动脉造影 ,测定其最大ST/HR斜率。结果　平板运动试验阴性患者最大ST/HR斜率诊断冠心病的敏感性为 6 8 2 % ,特异性为 80 8% ,准确性为 76 2 % ;运动峰值心率 <预计最大心率之 85 %组最大ST/HR斜率诊断冠心病的敏感性为 92 8% ,特异性为 86 7% ,准确性为 89 7% ,高于运动峰值心率≥预计最大心率之 85 %组。结论　平板运动试验阴性患者最大ST/HR斜率对冠心病的临床诊断有较高的敏感性、特异性和准确性 ,尤其是对低运动水平的患者 。Objective To elucidate the value of maximal segment/heart rate slope(ST/HR slope) of negative patient during tabular exercise test (TET) in diagnosing coronary artery disease(CAD).Methods The maximal ST/HR slope was measured in 122 patient who had clinic indication but negativity during TET. Results In diagnosing CAD,the sensitivity,specificity,accurary rate with the maximal ST/HR slope of negative patient during TET were 68 2%,80 8%,76 2% respectively. The sensitivity, specificity, accuracy rate in diagnosing of CAD with the maximal ST/HR slope in patient whose exercise peak heart rate achieved <85% of the maximal predicted heart rate were 92 8%,86 7%,89 7% respectively, it was higher than that in patient whose exercise peak heart rate achieved ≥85% of the maximal predicted heart rate.Conclusion The maximal ST/HR slope of negative patient during TET has higher sensitivity, specificity and accuracy rate in diagnosing CAD, especially for lower exercise level patients, it has significance to decrease the missed diagnosis in exercise test.

关 键 词：平板运动试验 最大ST/HR斜率 冠心病 诊断 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病] R540.47[医药卫生—内科学]