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分析运动平板试验临床应用价值

2019-11-08李水珠莫基斌

中外医疗 2019年23期
关键词:临床应用价值冠状动脉造影

李水珠 莫基斌

[摘要] 目的 通过比较运动平板试验与冠脉造影结果,分析其临床应用价值。 方法 方便收集2018年4—12月入住该院心内科75例疑似冠心病患者,所有患者均行运动平板试验与冠状动脉造影检查。结果 运动平板试验中阳性率72.0%,而冠状动脉造影术为53.3%,两者比较差异有统计学意义(χ2=4.688,P<0.05)。运动平板试验的灵敏度为82.5%。将结果按性别分别分析,男性患者和女性患者运动平板试验阳性率分别为72.7%、70.0%,而冠状动脉造影术分别为56.4%、45.0%,其中女性患者比较差异有统计学意义(χ2=7.013,P<0.05)。按受累血管数目分组为0支,单支,多支,运动平板试验阳性率分别为50.0%,75.0%,83.9%,3组间比较差异有统计学意义(χ2=7.076,P<0.05)。结论 运动平板试验对诊断冠心病的敏感性较好,且受累血管数目越多阳性率越高,可作为初筛冠心病的方法,但有假阳性现象,以女性患者影响更明显。因此在冠心病筛查时应多方面综合分析以提高诊断准确性。

[关键词] 运动平板试验;冠状动脉造影;假阳性;临床应用价值

[中图分类号] R541          [文献标识码] A          [文章编号] 1674-0742(2019)08(b)-0032-03

[Abstract] Objective To compare the clinical application value of exercise plate test and coronary angiography. Methods Convenient a total of 75 patients with suspected coronary heart disease who were admitted to our Department of Cardiology from April 2018 to December 2018 were enrolled. All patients underwent exercise plate and coronary angiography. Results The positive rate was 72.0% in the exercise plate test and 53.3% in the coronary angiography. The difference was statistically significant (χ2=4.688, P<0.05). The sensitivity of the exercise plate test was 82.5%. The results were analyzed by gender. The positive rate of exercise plate test in male patients and female patients was 72.7% and 70.0%, respectively, while coronary angiography was 56.4% and 45.0%, respectively. Among them, the difference was statistically significant (χ2=7.013, P<0.05). According to the number of affected vessels, the scores were 0, single, and multiple. The positive rate of exercise plate test was 50.0%, 75.0%, and 83.9%, respectively. The difference between the three groups was statistically significant (χ2=7.076, P<0.05). Conclusion The exercise plate test is more sensitive to the diagnosis of coronary heart disease, and the higher the number of affected blood vessels, the higher the positive rate. It can be used as a method for screening coronary heart disease, but there is a false positive phenomenon, which is more obvious in female patients. Therefore, in the screening of coronary heart disease should be comprehensive analysis in many aspects to improve the diagnostic accuracy.

[Key words] Exercise plate test; Coronary angiography; False positive; Clinical application value

隨着物质生活改善及社会压力对人体影响,近年冠状动脉粥样硬化性心脏病(冠心病)的发生率有所提高,且偏年轻化。目前虽然冠状动脉造影检查仍然是确诊冠心病的“金标准”,但运动平板试验较之相对安全、无创、简单、廉价且无需住院,更容易为患者接受,故常作为疑似冠心病患者的初步筛查手段。为此,该研就对2018年4—12月入住该院心内科75例疑似冠心病患者进行了运动平板试验,并对其展开分析讨论。现报道如下。

运动平板试验操作简单易于普及,且诊断冠心病的敏感性较好,可以作为冠心病初筛的常规检查方法。然而与冠脉造影检查对比,存在假阳性,因此临床中因结合患者性别、年龄、临床症状、既往病史等进行综合分析,必要时配合其他检查手段,如碘剂注射后对冠状动脉进行CT检查(CTA),甚至直接进行冠状动脉造影以明确。

[参考文献]

[1]  王慧,陈瑶,郭勇娟,等.浙江省心电图平板运动试验操作与诊断规范(试用版)[C]//浙江省医学心电与起搏学术分会.2016年浙江省医学会心电生理与起搏学术年会论文汇编.中国浙江湖州:2016.

[2]  巢为农,吴晶晶,王炳银,等.运动平板试验假阳性相关因素的分析[J].临床心电学杂志.2015,24(1):27-30.

[3]  张虹.运动平板试验假阳性结果与冠状动脉造影结果对比分析[J].河北医药.2013,35(11):1639-1641.

[4]  张晓红,和平,王科程,等.运动平板试验诊断冠心病诊断价值研究[J].临床军医杂志.2018,46(5):588-589.

[5]  张俊芳,张利峰,王献忠.运动平板试验诊断无症状糖尿病冠心病的临床意义[J].中西医结合心脑血管病杂志,2013, 11(1):108-109.

[6]  Peteiro J,Bouzas-Mosquera A,Broulion FJ,et al.Prognostic value of peak and post-exercise treadmill exercise echocardiography in patients with known or suspected coronary artery disease,Eur Heart J,2010,31(2):187-195.

[7]  梁子光.84例疑似冠心病患者心电图平板试验的临床应用分析[J].临床医药实践.2016,5(1):75-77.

[8]  黄素华, 黄继焕, 林小秀. 运动平板试验与动态心电图在中老年冠心病诊断中的应用价值分析[J]. 基层医学论坛, 2017, 21(13):1678-1679.

[9]  Yang H , Huang Z , Lou Y , et al. Limited value of recovery phase-limitedST segment depression of treadmill exercise test[J]. Chinese Medical Journal,2014, 127(4):742-746.

[10]  丁盛梅. 12导联动态心电图联合平板运动试验对冠状动脉粥样硬化性心脏病患者诊断敏感性及特异性的影响[J].中国药物经济学, 2017,12(9):130-132.

[11]  Carreira M A M Q , Nogueira André B, Pena F M , et al. Detection of Autonomic Dysfunction in Hemodialysis Patients Using the Exercise Treadmill Test: The Role of the Chronotropic Index, Heart Rate Recovery, and R-R Variability[J]. PLOS ONE,2015,10(6):123-128.

[12]  胡玉萍,屈莉,心電图平板运动试验对比动态心电图在冠心病的诊断中的应用价值[J].临床医学研究与实践, 2017,2(23):138-139.

(收稿日期:2019-05-19)

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