活动平板试验联合动态心电图对老年女性冠心病的诊断价值

目的探讨活动平板试验（TET）联合24h动态心电图（Hoher）检查对老年女性冠心病的诊断价值。方法纳入年龄在60岁以上拟诊冠心病的老年女性患者232例，入选病例全部行冠状动脉造影（CAG）、TE’I吸Holter检查，以CAG结果作为金标准，对单独及联合TET、Hoher法诊断冠心病及不同冠脉病变支数冠心病的敏感度、特异性等指标进行比较。结果TET诊断老年女性冠心病的敏感度74．2％、特异性73．9％；Holter诊断老年女性冠心病的敏感度66．9％、特异性79．7％；两者联合时敏感度84．7％、特异性为82．6％。单项检查与联合法对诊断冠心病的敏感度间的差异有统计学意义（P〈0．05）。联合法对冠状动脉单支、双支、三支血管病变冠心病诊断的敏感度均高于各单项检查诊断冠心病的敏感度，但只有对单支冠脉病变冠心病诊断的敏感度与各单项检查问有统计学差异（P〈0．05）。结论TET联合Hoher检查可提高对老年女性冠心病的诊断敏感度。

Diagnostic value of treadmill exercise test combining Holter in elderly female patients with coronary heart disease

Objective To investigate the diagnostic value of treadmill exercise test(TET) combining 24-hour Holter in elderly female patients with coronary heart disease(CHD).Methods All 232 elderly female patients with suspected CHD were selected and given the examinations of coronary angiography(CAG),TET and Holter.The result of CAG was taken as golden standard,and then the sensitivity and specificity of TET and Holter used singly or jointly were compared in the diagnosis of CHD and CHD involving different vessels diagnosed.Results The sensitivity of TET was 74.2% and specificity was 73.9%,and sensitivity of Holter was 66.9% and specificity was 79.7% for diagnosing CHD in elderly female patients.When they were used jointly,the sensitivity was 84.7% and specificity was 82.6%.The difference in sensitivity between single-used TET or Holter and joint-used of them had statistical significance(P<0.05).The sensitivity of the joint-used TET and Holter was higher for diagnosing CHD single-vessel,double-vessel and three-vessel disease than that of single TET or Holter,but only that for CHD single-vessel disease had statistical significance(P<0.05).Conclusion TET combining Holter can increase the sensitivity of diagnosis for CHD in elderly female patients.