平板运动试验对≥70岁老年冠心病的诊断价值

Diagnostic value of treadmill exercise test for coronary heart disease in patients aged 70 and over

目的分析平板运动试验作为老年人(年龄≥70岁)门诊冠心病常规检查方法的价值。方法选取303例疑似冠心病的病人,根据年龄分为≥70岁组和<70岁组,行平板运动试验检查后完善冠脉造影术,计算平板运动试验结果诊断≥70岁老年冠心病的检出率、特异性、阳性预测值和阴性预测值,分析其对冠心病不同病变血管检出率的差异。结果与<70岁人群相比,平板运动试验在≥70岁老年人群冠心病诊断中同样具有较高检出率、特异性、准确度、阳性预测和阴性预测。对≥70岁人群3支血管病变的检出率高于双支血管和单支血管病变(P<0.05),双支血管病变检出率高于单支血管病变(P<0.05)。不同部位血管病变的检出率差异无统计学意义(P>0.05)。结论平板运动试验可作为≥70岁老年人冠心病筛查的常规检查方法,并且冠脉病变累及血管数目越多,阳性检出率越高。

Objective To analyze the diagnostic value of treadmill exercise test as a routine examination method for coronary heart disease in the elderly patients aged≥70 years old.Methods A total of 303 patients with suspected coronary heart disease were selected and divided into≥70 years old group and<70 years old group.Coronary angiography was performed after treadmill exercise test.The accuracy,specificity,positive prediction and negative prediction of treadmill exercise test for coronary heart disease in the patients aged≥70 years old were calculated.Results Compared with those aged<70 years old,treadmill exercise test also showed higher specificity,accuracy,positive prediction and negative prediction in the diagnosis of coronary heart disease in the patients aged≥70 years old.The detection rate of triple vessel lesions in the patients aged≥70 years old was higher than that of double vessel and single vessel lesions(P<0.05).The detection rate of double vessel disease was higher than that of single vessel disease(P<0.05).There was no significant difference in the detection rate of different parts of vascular lesions(P>0.05).Conclusions Treadmill exercise test can be used as a routine examination method for coronary heart disease screening in the elderly aged≥70 years old,and the higher the number of vessels involved in coronary artery lesions,the higher the positive detection rate.