运动平板心电图及24h动态心电图对冠心病的诊断价值比较

Comparison of treadmill ECG, 24-hour holter in diagnosing coronary artery disease

目的 对24 h动态心电图和运动平板心电图在冠心病诊断中的阳性率、敏感性及特异性进行比较,为临床诊断提供参考.方法 选取漯河市第三人民医院2010年6月至2012年6月诊断的86例冠心病疑似病例为研究对象,采用随机数字表法将其分为观察组和对照组,分别采用24 h动态心电图和运动平板心电图进行诊断,以动脉造影检查结果为标准对两组研究对象的诊断准确性进行评价,并对诊断的阳性率、敏感性及特异性进行组间比较及统计学分析.结果 观察组阳性率为81.4%,对照组为62.8%,组间比较差异有统计学意义（ P〈0.05 ）;观察组准确率为83.7%,高于对照组的72.1%,差异有统计学意义（ P〈0.05 ）;在诊断的敏感性及特异性的比较中,观察组均优于对照组,差异有统计学意义（ P〈0.05 ）. 结论 运动平板心电图在冠心病的诊断中具有准确性高、阳性率高、敏感性强、特异性高及无创等优势,具有重要价值,适于临床推广使用.

Objective To compare the positive rate , sensitivity and specificity of 24-hour ambulatory electrocardi-ogram and treadmill ECG in the diagnosis of coronary artery disease , to provide reference for clinical diagnosis .Methods Eighty-six suspected cases of coronary heart disease from June 2010 to June 2012 were randomly divided into observation group and control group , they were diagnosed by 24-hour ambulatory electrocardiogram and treadmill ECG .The diagnostic accuracy of the two groups were evaluated by arteriography results , and the positive rate of diagnosis , the sensitivity and specificity of the two groups were compared and analyzed .Results Thirty-five cases were positive in observation group , the positive rate was 81.4%;and the positive rate was 62.8%in control group, the difference was significant （P〈0.05）;The accuracy rate of diagnosis of observation group （ 83.7%） was higher than that of control group （ P 〈0.05 ） , and the sensitivity and specificity of diagnostic of observation group were better than those of control group , and the differences were significant （ P 〈0.05 ） .Conclusions The treadmill ECG diagnosis of coronary heart disease has advantages such as high accuracy, positive rate, sensitivity, high specificity and non-invasive, so it＆#39;s suitable for clinical use.