平板运动试验及动态心电图对冠心病的诊断价值

Comparative Study on Treadmill Exercise Test and Holter in the Diagnosis of Coronary Heart Disease

目的探讨单独或者联合使用平板运动试验与动态心电图诊断冠心病心肌缺血的价值。方法筛选有不典型胸痛症状或可疑冠心病患者 180 例,每例患者均在行选择性冠状动脉造影前行平板运动试验及动态心电图检查,其结果与选择性冠状动脉造影结果相比较,分析平板运动试验、动态心电图诊断冠心病的筛选价值。结果单独使用平板运动试验诊断冠心病的敏感度为 80.00%、特异度为 81.33%;单独使用用动态心电图诊断冠心病的敏感度为 69.52%,特异度为 68.00%,两者相比较差异无统计学意义(P > 0.05);两者联合检测时,并联法的敏感度为 92.38%,阴性预测值为 84.31%,较其他组高;串联法的特异度为 90.67%,阳性预测值为 91.14%,较其他组高,差异有统计学意义(P< 0.05)。结论平板运动试验联合动态心电图检测,具有较高的敏感性和特异性,可以作为无创诊断冠心病的重要方法,对冠心病的诊断有重要价值。

Objective To discuss the value of treadmill exercise test(TET) examination and holter in diagnosing coronary heart disease. Methods 180 borderline cases of coronary heart disease were enrolled.TET and holter were performed before coronary angiography within one month in those patients. Results The sensitivity and specificity of treadmill exercise test were 80.00% and 81.33% respectively, and that of dynamic electrocardiogram was 69.52% and 68.00% respectively. There was no significant difference between them (P > 0.05). The sensitivity and negative predictive value of parallel method were 92.38% and 84.31% respectively, which were higher than those of other groups. The specificity was 90.67% and the positive predictive value was 91.14%, which was higher than that of other group (P < 0.05). Conclusion TET combined with holter has a higher sensitivity and specificity .TET combined with holter is an effective and safe noninvasive method for diagnosis of chronic heart disease.