动态心电图、平板运动试验与常规心电图对无症状心肌缺血的诊断价值比较

VALUES OF APPLYING DYNAMIC ELECTROCARDIOGRAM,TREADMILL EXERCISE TEST AND ROUNTINE ELECTROCARDIOGRAM IN THE DIAGNOSIS OF SILENT MYOCARDIAL ISCHEMIA

目的观察动态心电图(DCG),平板运动试验(TET)与常规心电图应用于无症状心肌缺血的临床诊断价值。方法回顾性分析2013—2014年该院接受治疗的90例冠心病患者的临床资料,将这90例患者1个月内经动态心电图,平板运动试验与常规心电图检测出无症状心肌缺血的敏感性、特异性以及符合率的结果进行对比分析,其中诊断无症状心肌缺血的金标准为冠状动脉造影。结果 90例中按照金标准诊断出的无症状心肌缺血患者为65例,动态心电图诊断无症状心肌缺血的敏感性为84.61%(55/65),特异性为52.00%(13/25),符合率为75.55%(68/90);平板运动试验的敏感性为89.23%(58/65),特异性为60.00%(15/25),符合率为81.11%(73/90);常规心电图的敏感性为58.46%(38/65),特异性为36.00%(9/25),符合率为52.22%(47/90)。结论动态心电图,平板运动试验对于诊断无症状心肌缺血要明显优于常规心电图,在临床实际操作中动态心电图更为方便,操作风险更小。

Objective To observe the values of applying dynamic electrocardiogram（DCG）,treadmill exercise test（TET）and routine electrocardiogram in the diagnosis of silent myocardial ischemia.MethodsClinical datas of 90 CHD（coronary heart disease）patients in author’s hospital from2013 to 2014 were respectively analyzed.The sensitivity,specificity and coincidence rates of 90 patients detected by DCG,TET and routine electrocardiogram for about one month were compared with the golden standard of coronary arteriography.Results In these 90 patients,65 patients were diagnosed with silent myocardia ischemia,and the sensitivity,specificity and coincidence rate of DCG were 84.61%（55/65）,52.00%（13/25）,75.55%（68/90）respectively,of TET were 89.23%（58/65）,60.00%（15/25）and81.11%（73/90）,and of routine electrocardiogram were 58.46%（38/65）,36.00%（9/25）and 52.22%（47/90）.Conclusion The accuracy of DCG and TET in the diagnosis of silent myocardial ischemia is higher than routine electrocardiogram,DCG is more easy to operate with low risk.