运动试验及动态心电图诊断冠心病的价值

Comparative study on treadmill exercise and dynamic ECG in the diagnosis of coronary heart disease

目的通过与冠状动脉造影结果的对比,评估平板运动试验,24h动态心电图(12导联)对冠心病的诊断价值。方法对81例临床拟诊为冠心病患者同时行运动心电图和24h动态心电图,以冠状动脉造影为标准进行分析对比。结果①平板运动试验对冠心病诊断的敏感性72.1%,特异性80.0%,12导联动态心电图对冠心病诊断的敏感性63.9%,特异性75.0%。平板运动试验与12导联动态心电图对冠心病诊断的敏感性和特异性略有差异,差异无统计学意义(p>0.05);②平板运动试验和12导联动态心电图对冠脉不同支数病变阳性检出率的对比,差异无统计学意义(p>0.05);③平板运动试验和12导联动态心电图对冠脉双支及多支病变的阳性检出率明显高于单支病变,差异有统计学意义(p<0.05)。结论平板运动试验和动态心电图是目前最简便实用和安全可靠的无创性诊断冠心病的方法,尤其对冠脉双支及多支病变的阳性检出率高,两者结合起来可提高冠心病诊断的准确性。

Objective By comparing with the results of coronary angiography, evaluate the value of treadmill test, 24 hour dynamic electrocardiogram in the diagnosis of coronary artery disease, and carries on the contrast and analysis. Methods Eighty one cases with clinically suspected coronary heart disease patients underwent treadmill exercise eleetroeardiogram and 24h dynamic electrocardiogram in coronary angiography as the standard, comparative analysis. Results （~）The sensitivity of TET for the diagnosis of coronary heart disease was 72.1%, the specificity was 80%, The sensitivity of 12 lead Hoher for the diagnosis of coronary heart disease was 63.9%, the specificity was 75% TET and 12 lead Holler sensitivity and specificity for the diagnosis of coronary heart disease is slightly different, there was no statistically significant difference （O〉0.05）; （~）Comparison of TET and 12 Hoher on different positive rate of coronary artery lesions, no significant difference （p〉0.05）; （~TET and 12 lead Holter on the coronary muhivessel disease dotlble branch and the positive rate was significantly higher than that of single branch lesion, the difference was statislically significant （o〈0.05）. Conclusion TET and Hoher are currently the most convenient, safe and reliable noninvasive method in diagnosis of CHD, especially on coronary double teams and multivessel disease, the combination of the them can improve the accuracy of diagnosis of coronary heart disease.