【摘要】 目的 :评价运动平板试验在现代冠心病诊断中的价值 ,尤其对多支病变患者。方法 :对 95例同时行运动平板和冠状动脉造影结果进行对比分析。结果 :运动平板试验阳性者 6 2例 ,冠状动脉造影检查确诊冠心病 49例 (79%) ;运动平板试验诊断冠心病的敏感度是 79%,特异度是 91%,预测准确是 79%。运动平板试验的敏感度与冠状动脉的病变范围有关 ,多支病变 (≥ 2支病变 )敏感度 89%明显高于单支病变敏感度 6 3%。预测敏感度与病人临床症状相关 ,典型心绞痛 ,预测准确性为 86 %,不典型心绞痛者 ,仅为 2 2 %。运动平板试验早期出现心肌缺血 ,运动诱发心肌缺血 ,提示多支病变。本文中多支病变者心电图出现ST段压低≥ 1mm时间为较单支病变为短。结论 :运动平板试验的敏感度和特异度较高 ,在现代冠心病诊断中仍具有价值 ,尤其是多支血管病变患者。更多还原

【Abstract】 Objective: To assess the diagnotic value of Treadmill exercise test in patientswith coronary heart disease,easpecialy in patients with multi-vessel disease, Method: To analyze contrastively the results of Treadmill exercise test and findingsof selective coronary angiography in 95 patients.Results:49 patients (79%) werefound coronary heart disease by coronary angiography in 62 patients withpositive Readmill exercise test .Among 33 patients with negative Readmill exercise test 3(9%) were diagnosed coronary heart disease by coronary angiography .The sensitivity and specialty of Readmill exercise test were 79% and 91%respectively.The accuracy of readmill exercise test was 79%. The sensitivity of Treadmill exercie test was associated with extent of coronary involvement and it was higher in patients with multi-vessel disease than those with single-vessel disease (89%Vs63%).The accuracy of Treadmill exercise test was higher in patients with typical angina than that in atypical angina (86%Vs22%).Myocardial ischemia induced at early stage of Treadmill exercise test, it indecated muti-vessel disease.So the onset time of exercise induced myocardial ischemia (identified by electrocardiogram with ST segment depressing≥1mm)in patients with muti-vessel was significantly less than that in patients with sigle-vessel. Conclusion: The sensitvity and specialty of Treadmill exercise test were higher,it was valuable in diagnosing modern coronary heart diseade , especialy in patients with multi-vessel disease.更多还原