三种无创检查对冠心病的诊断价值

Evaluation of three noninvasive examinations in diagnosis of coronary heart disease

目的探讨平板运动试验(TET)、动态心电图(Holter)和超声心动图(UCG)检查对冠心病的诊断价值。方法189例因胸闷、心前区疼痛拟诊冠心病患者,行TET、Holter、UCG检查,并以冠状动脉造影(CAG)检查结果为金标准评价三项无创检查的诊断价值。结果CAG检查确诊冠心病108例,TET、Holter和UCG诊断冠心病的敏感性分别为70.4%、57.4%和44.4%,特异性分别为69.1%、60.5%和81.5%;联合两种检查诊断冠心病的敏感性依次为TET+Holter89.8%、TET+UCG73.3%和Holter+UCG71.1%,特异性依次为TET+Holter75.8%、TET+UCG73%和Holter+UCG69.2%。结论三种无创检查中,TET诊断冠心病的敏感性最高,UCG特异性最高但敏感性差;联合任何两种无创检查方法均可提高诊断冠心病的符合率。

Objective To evaluate the effectiveness of three noninvasive examinations in the diagnosis of coronary heart disease （CHD）. Methods Treadmill exercise test （TET）, Holter, echoeardiograpy（UCG） and coronary angiography（CAG） were performed in 189 patients with a history of chest pain. A positive finding of CAG was taken as the criteria for CHD. The sensitivity and specificity of the three noninvasive examinations were analyzed. Results The sensitivities of TEl＇, Holter and UCG were 70.4%,57.4% and 44.4%, respectively. The specifieities of them were 69.1%, 60.5% and 81.5 %, respectively. The sensitivities of TET＋ Hloter, TET＋ UCG and Holter ＋ UCG were 89.8%, 73.3% and 71.1%, respectively. The specificities of them was 75.8%, 73% and 69.2%, respectively. Conclusion TET has a high sensitivity and specificity for diagnosing CHD, but UCG has a high specificity but poor sensitivity. Accuracy of diagnosis can be improved by combining two of noninvasive examinations.