150例平板运动试验阳性患者冠脉造影结果分析

Analysis of coronary angiographic results of 150 exercise treadmill test positive patients

目的探讨平板运动试验对冠心病的诊断价值。方法对150例平板运动试验(TET)阳性患者行冠状动脉造影术(CAG),根据冠脉造影结果分为真阳性组与假阳性组,比较两组患者年龄、性别的差异;统计真阳性组患者病变支数与性别的相关性;比较两组ST段偏移导联的差别;分析两组的运动试验参数与CAG的关系。结果①平板运动试验真阳性率为60%,其中男性为64.29%,女性为47.37%。②在真阳性组中男性患单支、双支及多支病变的比例明显高于女性,差异有统计学意义(P<0.05)。③下壁导联ST段改变假阳性率高(P<0.05)。④运动总时间、最大ST段下移幅度、ST段下移出现时间及ST段下移持续时间的比较显示,两组之间有显著性差异(P<0.05)。结论平板运动试验是一项诊断冠心病较理想的非创伤性检查方法。如果运动中结合多项运动参数全面综合分析,可以提高诊断准确率。

Objective To estimate the diagnostic value of exercise treadmill test（TET） for coronary heart disease. Methods Carry out coronary angiography（CAG） on 150 patients with positive TET results. According to CAG results, divide them into true-positive group and false-positive group, and then compare the differences of age and sex between the two groups. Statistically analyse the correlation between the amount of diseased vessels and sex in true-positive group; Compare the difference of leads whose ST-segments shifted between the two groups and analyse the relationship between the TET parameters and CAG. Results ① True-positive rate of TET is 60%, with 64.29% in males and 47.37% in females. ② In true-positive group, the proportion of males who are single-vessel, double-vessel and multi-vessel diseased is significantly higher than that of females and the difference is statistically significant（ P 〈 0. 05 ）. ③ False-positive rate is high when ST-segments change in inferior leads （P 〈 0. 05 ）. ④ There lie significant differences between the two groups in aspects of total movement time complicated with the amplitude, time of occurrence and lasting time of downward shifting of ST-segments （ P 〈 0. 05 ）. Conclusion TET is an ideal non-invasive testing method to diagnose coronary heart disease. Diagnostic accuracy can be improved if va- rious exercise parameters are combined while comprehensive analysis is carried out.