运动平板与食道调搏心脏负荷试验诊断冠心病临床应用.docVIP

运动平板与食道调搏心脏负荷试验诊断冠心病临床应用 　　[摘要] 目的:评价运动平板试验与食道调搏心脏负荷试验对冠心病的诊断价值。方法:我院对临床诊断冠心病组186例及临床健康对照组178例进行食管调搏负荷试验,并同期进行运动平板负荷试验作对照。结果:冠心病组食道调博心脏负荷试验的敏感性、特异性分别为86.3%及81.6%,运动平板负荷试验的敏感性及特异性分别为85.3%、78.9%,二者联合则敏感性、特异性分别为98.9%及98.8%。结论:运动平板与食道调搏心脏负荷试验具有无创、安全、简便、有效的特点,投入少、费用低、容易掌握,二者联合诊断冠心病则可明显提高敏感性和准确性,因此适合在基层医院推广。 　　[关键词] 运动平板;食道调搏;冠心病;诊断 　　[中图分类号] R541.4[文献标识码]A[文章编号]1673-7210(2009)07(a)-079-02 　　 　　Clinical application of treadmill exercise test and transesophageal atrial pacing incoronary heart disease 　??GUO Lidong, JIANG Zhizhong, CHEN Gang 　　(Cardiology Department,Conghua Centre Hospital, Conghua City of Guangzhou Province, Conghua510900, China) 　　[Abstract] Objective: The relation of the changes of treadmill exercise test(TET) and transesophageal atrial pacing(TEAP) with the region of coronary artery disease was investigated. Methods:TET and TEAP were done for 186 coronary heart disease group patients and 178 contrastgroup patients. Results:The region of coronary artery disease was investigated.The trial sensitivity ofTEAP was 86.3%, the particularity ofTEAP was 81.6%, the trial sensitivity of TET was 85.3%the particularityof TET was 78.9%, two consociation then sensitivity, particularity distinguish were 98.9% and 98.8%. Conclusion:Clinical application of TET and TEAP in coronary heart disease, they are non-invasion, safe, simple and effective, low expenses, easily control. Two consociation diagnosis for the coronary can obviously raise sensitivity and accuracy, so it is suitable to expand in the grass-roots hospital. 　　[Key words] TET; TEAP; Coronary heart disease; Diagnosis 　　 　　冠心病发病率近年来呈增长趋势,及早明确诊断和进行规范化治疗可明显提高生存率和生活质量,降低死亡率,其诊断依靠症状、体征、实验室检查如发作时心电图改变、心电图负荷试验、冠状动脉造影等以及硝酸甘油的疗效。运动平板试验(TET)与食道调搏(TEAP)心脏负荷试验具有无创、安全、简便、有效的特点,投入少、费用低、容易掌握,二者联合诊断冠心病则可明显提高敏感性和准确性,现报道如下: 　　1 资料与方法 　　1.1 一般资料 　　冠心病组选择2007年1月～2008年11月住院患者中冠心病患者186例,男112例,女74例;年龄40～75岁,平均(65±7.4)岁;均按WHO冠心病标准诊断,并排除糖尿病、心肌病、高血压病等疾患。另取对照组178例,经各项常规检查未发现有器质性心脏病,男104例,女74例;年龄40～76岁,平均(66±8.3)岁。 　　1.2 方