平板运动试验Duke评分对冠心病诊断的价值（英文）

Value of treadmill test Duke score on diagnosis of coronary heart disease

目的:探讨平板运动试验Duke评分对冠心病诊断的价值。方法:选择疑诊冠心病的患者200例,两周内分别完成生化检查、平板运动试验及冠脉造影检查,对平板运动试验Duke评分(DTS)及冠脉造影结果进行比较分析。结果:冠脉造影结果被视为诊断冠心病的金标准。(1)与平板运动试验比较:单独DTS阳性诊断冠心病的特异性(72.3%比55.4%,x^2=5.161,P=0.021)显著降低;运动试验联合DTS显著提高诊断冠心病的敏感性(72.6%比87.8%,x^2=7.860,P=0.005)、阴性预测值(56%比76.9%,x^2=6.128,P=0.013);(2)与DTS阳性比较,运动试验联合DTS显著提高诊断冠心病的敏感性(76.3%比87.8%,x^2=4.334,P=0.037)、阴性预测值(52.9%比76.9%,x^2=7.298,P=0.007)、准确性(69.5%比80.8%,x^2=5.849,P=0.016)。结论:联合应用运动试验及Duke评分可显著提高诊断冠心病的敏感性、阴性预测值和准确度。

Objective： TO explore value of treadmill test Duke score on diagnosis of coronary heart disease （CHD）. Methods： A total of 200 patients suspected CHD were selected. All patients received biochemical examinations, treadmill exercise test （TET） and coronary angiography （CAG） within two weeks. The results of TET, Duke＋readmill score （DTS） and CAG were compared and analyzed. Results： The CAG was regard as gold standard diagnosing CHD. （1） Compared with TET alone, there were significant decrease in specificity （72.3% vs. 55.4%, Х^2= 5. 161, P=0. 021） in positive DTS alone for diagnosing CHD; there were significant increase in sensitivity （72.6% vs. 87.8%, 7.2=7.860, P=0.005）, negative predictive value （56% vs. 76.9%, Х^2=6.128, P=0.013） in combined use of TET and DTS for diagnosing CHD; （2） Compared with positive DTS alone, there were significant increase in sensitivity （76.3% vs. 87. 8%, Х^2=4. 334, P=0. 037）, negative predictive value （52. 9% vs. 76.9%, Х^2=7. 298, P=0. 007） and accuracy （69.5% vs. 80. 8%, Х^2=5.849, P=0. 016） in combined use of TET and DTS. Conclusion： Combined use of treadmill exercise test and Duke score can significantly increase sensitivity, negative predictive value and accuracy diagnosing CHD.