平板运动试验及其Duke评分诊断绝经期女性冠心病的价值

Diagnostic value of treadmill exercise test and its Duke score in menopausal women with coronary heart disease

目的:探讨平板运动试验(TET)及其Duke评分对绝经期女性冠心病患者的诊断价值。方法:对绝经期女性患者102例行TET和冠状动脉造影(CAG)检查。以CAG为对照,比较TET结合Duke评分对绝经期女性患者冠状动脉疾病诊断的准确性等指标,并做统计学分析。结果:与单独应用TET或Duke评分比较,TET联合Duke评分两项均阳、均阴性的诊断冠心病的特异性(27.12%比30.50%比44.44%)、阳性预测值(47.56%比46.75%比54.55%)、阴性预测值(80%比72%比90.91%)、准确性(53.92%比52.94%比64.94%)均明显提高(P均<0.05);但敏感性无显著差异(P均>0.05)。单独应用TET或Duke评分诊断冠心病无显著差异(P均>0.05)。结论:绝经期女性运动平板试验假阳性率较高,结合运动平板试验Duke评分有助于提高试验的特异性、阳性预测值、阴性预测值和准确性。

Objective：To explore the diagnostic value of treadmill exercise test（TET）and its Duke score in menopausal female patients with coronary heart disease（CHD）.Methods：A total of 102 menopausal female patients received TET and coronary angiography（CAG）examination.With CAG as control,accuracy indexes etc.of TET combined Duke score diagnosing coronary artery disease in these patients were compared and analyzed.Results：Compared with single application of TET or Duke score,there were significant rise in specificity（27.12% vs.30.50% vs.44.44%）,positive predictive value（47.56% vs.46.75% vs.54.55%）,negative predictive value（80%vs.72% vs.90.91%）and accuracy（53.92% vs.52.94% vs.64.94%）diagnosing CHD by TET combined Duke score both positive and negative,P〈0.05all;but there was no significant difference in sensitivity,P〈0.05 both.There was no significant difference in CHD diagnosis between single use of TET and Duke score,P〈0.05 all.Conclusion：False positive rate of treadmill exercise test is higher in menopausal women.Treadmill exercise test combined Duke score is helpful to improve specificity,positive predictive value,negative predictive value and accuracy of the test.