心脏变时功能不全对冠心病的诊断价值

Diagnostic value of chronotropic incompetence in coronary heart disease

目的:探讨心电图平板运动试验(treadmill exercise test,TET)中心脏变时功能不全(chrono-tropic incompetence,CI)诊断冠心病(coronary heart disease,CHD)的价值。方法:选择233例进行了TET与冠状动脉造影(coronary angiography,CAG)的患者,以CAG为诊断CHD的标准,比较TET传统指标与CI判断CHD的敏感性、特异性和准确性。结果:单纯CI指标诊断CHD的敏感性(81.7%)、特异性(64.3%)、准确性(71.2%)与TET传统指标诊断CHD的敏感性(73.1%)、特异性(69.3%)、准确性(70.8%)相比,差异无统计学意义(P>0.05);而联合TET传统指标和CI指标,则诊断CHD的特异性(87.9%)和准确性(79.4%)均显著高于传统指标(P<0.05);敏感性无明显变化(P>0.05)。结论:CI是诊断冠心病的有用指标,与TET传统指标相结合可显著提高TET诊断CHD的特异性和准确性。

Objective To determine the diagnostic value of chronotropic incompetence （CI） in coronary heart disease （CHD）. Methods Two hundred thirty three patients who underwent the electrocardiogram treadmill exercise test （TET） and coronary angiography （CAG） were included in this study. CAG was used as the standard of diagnosing CHD. The sensitivity, specificity, and accuracy of CI were compared with the traditional index of TET. Results There was no significant difference between the sensitivity, specificity and accuracy of CI （81.7% , 64. 3% , and 71.2% respectively） and those of the traditional index （73. 1% , 69. 3% , and 70. 8% respectively, P 〉 0.05）, while the specificity （87.9%） and accuracy （79.4%） were significantly higher after combining CI and the traditional index than that of the traditional index alone （ P 〈 0.05 ）. There was no significant difference in the sensitivity （ P 〉 0.05 ）. Conclusion CI was a usefull index in diagnosing CHD. CI combined with the traditional index of TET can significantly improve the specificity and accuracy of TET for CHD.