【摘要】 目的:探讨平板运动试验联合心脏彩超诊断冠心病及其病变程度的意义。方法:回顾400例初步诊断为冠心病患者的临床资料,以冠脉造影为金标准,分析并比较平板运动试验、心脏彩超、平板运动试验联合心脏彩超三种检查方法的灵敏度,特异性,及不同病变支数的阳性检出率。结果:与平板运动试验、心脏彩超比较,联合检查诊断冠心病的敏感性显著降低(80.67%、68.07%比54.20%),特异性显著升高(74.07%、64.82%比90.74%),P均<0.01。平板运动试验、心脏彩超和联合检查三种方法的阳性检出率随着冠脉病变支数增加而增加。与平板运动试验、心脏彩超比较,联合检查对单支病变(72.32%、56.25%比83.93%)、双支病变(85.92%、71.83%比97.18%)和多支病变(90.91%、87.27%比98.18%)患者阳性检出率均显著升高(P<0.05或<0.01)。结论:平板运动试验联合心脏彩超检查诊断冠心病的特异性显著优于单纯平板运动试验或心脏彩超,而且冠心病病变支数越多,阳性检出率越高。更多还原

【Abstract】 Objective:To explore diagnostic significance of treadmill exercise test(TET) combined echocardiography(ECG) for coronary heart disease(CHD) and its severity. Methods: Clinical data of 400 patients who were initially diagnosed as CHD were retrospectively analyzed. With coronary angiography as gold standard, sensitivities and specificities of single TET, single ECG and TET + ECG, and positive detection rate of different number of diseased vessels were analyzed. Results:Compared with single TET and single ECG, there was significant reduction in sensitivity(80.67%, 68.07% vs. 54.20%) and significant rise in specificity(74.07%, 64.82% vs. 90.74%) in TET + ECG, P<0.01 all. Along with number of diseased coronary vessels rose, positive detection rates of single TET, single ECG and TET + ECG increased. Compared with single TET and single ECG, there were significant rise?in positive detection rates of single vessel coronary disease(72.32%, 56.25% vs. 83.93%), double vessel coronary disease(85.92%, 71.83% vs. 97.18%) and multi vessel coronary disease(90.91%,87.27% vs.98.18%) in TET + ECG, P<0.05 or <0.01. Conclusion: Diagnostic specificity of TET + ECG is significantly better than those of single TET and single ECG; when number of diseased coronary vessels gets more, positive detection rate of TET + ECG is more significant.更多还原