平板运动试验Duke评分对冠心病的诊断价值

Diagnostic Value of Duke Treadmill Score Based on Treadmill Exercise Test in Patients with Coronary Heart Disease

目的:探讨平板运动试验(treadmill exercise test,TET)Duke评分(Duke treadmill score,DTS)在冠心病诊断中的价值及性别对诊断结果的影响。方法:选择2010年5月至2012年12月在本院就诊的疑诊冠心病,并在1周内接受了TET和冠脉造影检查的患者142例,依据性别分为男性组和女性组,将两组患者TET及DTS结果与冠脉造影结果进行比较分析。结果:男性组TET诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值、准确率均高于女性组,差异有统计学意义(P<0.01或P<0.05);女性组DTS诊断冠心病的特异性较男性组高,差异有统计学意义(P<0.05);男性组组内比较,DTS诊断冠心病的特异性、阳性预测值、阴性预测值、准确率高于TET,差异有统计学意义(P<0.01或P<0.05);女性组组内比较,DTS诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值、准确率高于TET,差异有统计学意义(P<0.01或P<0.05)。结论:平板运动试验Duke评分对冠心病的诊断价值优于单纯的TET,且不受性别因素的影响。

Objective To explore the value of Duke treadmill score( DTS) based on treadmill exercise test( TET) in the diagnosis of coronary heart disease( CHD) and the influence of gender on the diagnostic result. Methods From May 2010 to December 2012,142 patients suspected with CHD,who underwent TET and coronal artery angiography in one week were selected and randomly divided into two groups according to gender. The diagnostic results of TET and DTS were compared with that of coronal artery angiography. Results The sensitivity,specificity,positive and negative predictive values,accuracy of TET in male group were significantly higher than those in female group( P < 0. 01 or P < 0. 05). The specificity of DTS in female group was significantly higher than that in male group( P < 0. 05). The specificity,positive and negative predictive values,accuracy of DTS were significantly higher than those of TET within male group( P < 0. 01 or P < 0. 05). The sensitivity,specificity,positive and negative predictive values,accuracy of DTS were significantly higher than those of TET within female group( P < 0. 01 or P < 0. 05). Conclusion The value of DTS based on TET is better than single TET in diagnosis of CHD,and the accuracy of DTS has no relationship with gender.