【摘要】 目的　活动平板运动试验对冠心病的诊断价值。方法　对 44 7例怀疑冠心病患者的冠脉造影、活动平板试验结果 ,以及主要危险因素进行比较分析。结果　活动平板试验对冠心病诊断的敏感性 90 3 %、特异性为 19 6%、阳性预测值为 65 1%、阴性预测值为 5 5 0 %、假阴性率为 9 7%;多支冠脉病变患者与单支血管病变者比较 ,前者ST段下移程度更严重、出现下移的时间较早、持续时间更长、达到最大心率所需的运动负荷量较少 ;冠脉造影异常患者 (包括冠脉狭窄和内膜病变 ) ,72 5 %存在≥ 2冠心病的主要危险因子。结论　①活动平板试验是较好的筛选冠心病无创性方法 :活动平板阴性基本上可以除外冠心病 ;活动平板阳性加上≥ 2个主要的冠心病危险因素 ,冠心病的可能性较大。②活动平板在一定程度上也能反映冠脉病变程度和范围更多还原

【Abstract】 Objective To evaluate the diagnostic value of treadmill exercise test for coronary heart disease. Methods The results of coronary angiography, exercise treadmill test, and the main risk factors of 447 patients suspected of coronary heart disease were analyzed. Results Treadmill exercise test for coronary artery stenosis resulted in 90 3% sensitivity, 19 6% specificity, 65 1% positive predictive value, and 55 0% negative predictive value. Compared with patients with single vessel disease, lower, earlier, and longer lasting ST segment depression and less exercise burden for the maximum heart rate were found in those with multiple vessel disease. A total of 72 5% patients with coronary artery lesion (including coronary stenosis and coronary tunica intima lesion) had more than 2 risk factors. Conclusion Treadmill exercise test is a good non invasive method for screening of coronary heart disease: (1) negative result of treadmill exercise test can be used to exclude coronary heart disease, but positive result of treadmill exercise test plus more than 2 risk factors can predict the likelihood of coronary heart disease; (2) the treadmill exercise test can also reflect the degree and the range of coronary artery lesion.更多还原