等负荷运动心电图、二维超声心动图及心肌灌注断层显像对冠心病的诊断价值

The value of the same stress electrocardiognun exercise test, 2-dimensional echocardiographm and myocardial perfusion tomog- raphy imaging in diagnosis of coronary artery disease

对28例冠状动脉造影阳性和18例冠状动脉造影阴性患者进行等负荷运动心电图(运动ECG)、二维超声心动图(2-DE)及心肌灌注断层显像(SPECT)试验。结果表明:单项负荷试验以SPECT敏感性最高、2-DE的特异性最高,而运动ECG的敏感性及特异性则介于二者之间;联合负荷试验三项均阳性诊断冠心病的可靠性最大,二项阳性有诊断冠心病的可能.一项阳性诊断冠心病的可能性小,阳性意义需结合临床考虑,三项阴性者可排除冠心病。认为三项等负荷试验联合判定是筛选和诊断冠心病的准确、可靠的无创性检查方法。

28 cases of coronary angiographic positive patients(cor-ronary artery disesase group CAD group)and 18 cases negative ones(normal group)were examined by the same stress electrocardiogram exercise test,2-dimentional echocardiography and myocardial perfusion tomography imaging.The sensitivity of these 3 tests in diagnosing CAD were 82.1 %,71.4% and 96.4% respectively,and the specificity were 77.8%,88.9% and 55.6% respectively.In CAD group,64.3% were positive in all 3 tests,28.6% were positive in 2 tests,and 3.6% were positive in only 1 test.In normal group,11.1% were positve in all 3 tests,none were positive in 2 tests,38.9 % were positive in 1 test,and 50% were all tests negative.Conclusion: It was an accurate,reliable and noninvasive method to combine these 3 tests in screening and diagnosing CAD.