平板运动试验心脏变时指数诊断冠心病的价值

The clinical significance of CI during treadmill test in the diagnosis of coronary heart disease

目的探讨平板运动试验心脏变时性指数(CI)对冠心病的诊断价值。方法对694例拟诊为冠心病的患者(男514例,女180例)先行平板运动试验,测定试验过程中患者心电图ST段变化值和心脏变时性指数,随后行冠状动脉造影检查,以冠状动脉造影结果作为诊断冠心病的标准。结果①平板运动试验中,传统ST段改变的敏感性、特异性及准确性分别为66.6%7、67.36%、70.15%;②ST段指标联合CI的敏感性、特异性及准确性分别为75.55%、83.66%、81.34%。CI与冠状动脉病变支数相关,CI平均值从0支冠状动脉病变的1.03±0.25,逐渐下降到3支冠状动脉病变的0.52±0.24(p<0.05)。结论①平板运动试验中ST阳性结合CI可提高诊断冠心病的特异性(p<0.05);②CI与冠状动脉病变支数相关,CI可作为诊断冠心病的一种有效指标。

Objective To investigate the clinical significance of CI（Chronotropic Incompetence）during treadmill test in the diagnosis of coronary heart disease.Methods Five hundred and ninty-eight patients who were to be diagnosed the coronary heart disease received treadmill test and CAG examination.the sensitivity,specificity and accuracy of the index ST were compared with that of the index ST combined CI.Results The sensitivity,specificity and accuracy of index ST（＋）in coronary heart disease patients were 66.67%,67.36%,70.15%;ST index combined with CI were75.55%,83.66%,81.34%.ThechangeofCI isrelated to the quantity of the diseased coronary artery.From patients without coronary artery disease to three coronary arteries related,the mean value of CI（1.03±0.25）gradually decrease to 0.52±0.24.Conclusions ST（＋）index combined with CI increase the specificity of diagnosis in coronary heart disease.The change of CI is related to the quantity of the diseased coronary artery.It may be a useful accurate index in diagnosing coronary heartdisease.