12导联动态心电图与平板运动试验诊断冠心病心肌缺血的临床对比分析

Clinical comparative analysis of 12-lead dynamic electrocardiogram and treadmill exercise test in the diagnosis of myocardial ischemia in patients with coronary heart disease

目的探讨12导联动态心电图与平板运动试验诊断冠心病心肌缺血的临床诊断价值。方法选择2018年1月至2019年6月我院收治的78例疑似冠心病心肌缺血患者作为研究对象,均行冠状动脉造影、12导联动态心电图及平板运动试验,将冠状动脉造影作为检测“金标准”,评估并对比12导联动态心电图及平板运动试验的诊断效能。结果78例疑似冠心病心肌缺血患者中,经冠状动脉造影检查确诊30例;12导联动态心电图检测敏感度为61%(23/38),特异度为82%(33/40),准确率为72%(56/78);平板运动试验敏感度为73%(27/37),特异度为73%(30/41),准确率为73%(57/78);12导联动态心电图与平板运动试验的特异度、敏感度、符合率及总诊断率(71%和73%)对比,差异均无统计学意义(P>0.05)。结论2种诊断方法对冠心病心肌缺血均具有较高的诊断价值,能够作为辅助诊断方法,实际应用时应根据具体情况选择。

Objective To evaluate the clinical diagnostic value of 12-lead dynamic electrocardiogram(ECG)and treadmill exercise test in the diagnosis of myocardial ischemia in coronary heart disease(CAD).Methods A total of 78 patients with suspected coronary heart disease with myocardial ischemia were selected in our hospital from January 2018 to June 2019.Coronary angiography,12-lead dynamic electrocardiogram and treadmill exercise test were performed.Arteriography was used as the"gold standard"to evaluate and compare the diagnostic efficacy of 12-lead dynamic electrocardiogram and treadmill exercise test.Results Among 78 patients with suspected coronary heart disease and myocardial ischemia,30 patients were diagnosed by coronary angiography and 12-lead dynamic electrocardiogram.The sensitivity,specificity and accuracy of 12-lead dynamic electrocar diogram and treadmill exercise test were 61%(23/38),82%(33/40)and 72%(56/78),73%(27/37),73%(30/41)and 73%(57/78),respectively.There was no significant significance for the total diagnostic rate(71%vs 73%)(P>0.05).Conclusion The two diagnostic methods have high value in the diagnosis of coronary heart disease and myocardial ischemia,and the two methods have advantages and can be used as auxiliary diagnostic methods.