动态心电图联合运动平板试验诊断冠心病临床价值.docVIP

动态心电图联合运动平板试验诊断冠心病临床价值[摘要] 目的：探讨动态心电图单独与联合运动平板试验诊断冠心病的临床价值。方法：选取175例疑似冠心病患者，入院后2周内完成Holter和TET检查，间隔2周以上行冠脉造影检查，比较3种方法阳性率以及单用Holter或TET与联合检测对血管病变的敏感性。结果：单用两种方法对各种数量冠脉病变检出敏感性之间差异无统计学意义（P0.05），联合检测特异性为100.0%，阳性预测值为94.4%。结论：两者联合检测冠心病能做到无创、简单、安全，在保证诊断敏感性的前提下，减少了患者医疗费用。 [关键词] 动态心电图；运动平板试验；冠脉造影；冠心病 [中图分类号] R544 [文献标识码]B[文章编号]1673-7210（2011）07（c）-144-02 The clinical value of holter combiened with exercise treadmill test in the diagnosis of coronary artery disease LU Yongling Department of Cardiology, the People’s Hospital of Wuzhou City, Guangxi Zhuang Autonomous Region, Wuzhou 543000, China [Abstract] Objective: To evaluate the clinical value of holter combiened with exercise treadmill test in the diagnosis of coronary artery disease. Methods: 175 patients with holter within 2 weeks after admission and TET check interval of 2 weeks or more coronary angiography, the positive rate of 3 methods were compared with holter or combined with TET sensitivity of detection of vascular disease. Results: Detection sensitivity of various number of coronary lesions had no significant difference between the two methods (P0.05), joint detection specificity was 100.0%, positive predictive value was 94.4%. Conclusion: The combination of the two non-invasive detection of coronary artery disease is an simple, safe, guaranteed method of diagnostic, it can reduce patient care costs. [Key words] Holter; Exercise treadmill test; Coronary angiography; Coronary heart disease 动态心电图（Holter）与平板运动试验（TET）是两项无创、简单、安全而有效的临床监测方法，它们分别从不同角度反映冠心病心肌缺血的改变，对冠心病心肌缺血都有较高的诊断价值[1]。本研究采用Holter与TET联合诊断冠心病，并与冠脉造影结果进行比较，现报道如下： 1 资料与方法 1.1 一般资料 选择我院2010年1月~2011年1月心内科收治的疑似冠心病患者175例，入院时均有胸闷、胸痛、气短、心悸等可疑冠心病表现，经超声心动图检查排除高血压心脏病、心瓣膜病以及心肌病等。其中，男103例，女72例，年龄43~76岁，平均（53.6±9.1）岁；稳定型心绞痛23例，不稳定型心绞痛2例，陈旧性心梗2例。入院后所有患者在2周内完成Holter和TET检查，间隔2周以上行冠脉造影检查。 1.2 方法 运动平板试验采用秦皇岛市康泰医学系统有限公司的康泰8000平板试验检测仪，运用修正Bruce运动平板方案进行。运动终止标准是：①发作心绞痛，②达到目标心率；③运动中出现典型ST-T改变；④严重心律失常；⑤患者不能坚持；⑥血压下降20 mm Hg或收缩压升高220 mm Hg。阳性标准