血红蛋白水平对平板运动试验阳性结果诊断价值的影响

目的研究血红蛋白水平对平板运动试验阳性结果诊断价值的影响。方法选择2010年1月到2016年12月因胸痛或胸闷怀疑冠心病行平板运动试验阳性和冠状动脉造影者300例,造影结果显示主要血管狭窄≥70%的137例(阳性组),<70%163例(阴性组),分析比较临床资料及对运动平板试验阳性结果预测值的影响。结果阳性组的血红蛋白、尿酸、肌酐、甘油三酯、男性比例、吸烟比例和高血压比例明显高于阴性组,红细胞分布密度(RDW)、高密度脂蛋白胆固醇(HDL-C)低于阴性组,差异均有统计学意义(均P<0.05)。单因素和多因素logistic回归分析血红蛋白是平板运动试验阳性患者预测冠心病的独立预测因素。ROC曲线分析,血红蛋白曲线下面积0.702(P<0.01),血红蛋白≥137g/L,其敏感度为60.58%,特异度为74.85%。结论血红蛋白水平会影响平板运动试验阳性结果的诊断价值。

The influence of hemoglobin level on diagnostic value of positive exercise treadmill test

Objective To evaluate the influence of hemoglobin level on diagnostic value of positive exercise treadmill test(ETT).Methods 300 people with positive ETT underwent coronary angiography(CAG)for chest pain or suspicious coronary artery disease(CAD)from January 2010 to December 2016.Of them,137 cases had coronary artery stenosis≥70%(positive group)and 163 case had coronary artery stenosis<70%(negative group)based on CAG.Clinical data were analyzed and their influences on prediction value of positive result of ETT were determined.Results Hemoglobin,uric acid,creatinine,triglyceride,and the ratios of male,smokers and hypertension were significantly higher in positive group than in negative group,patients in positive group had lower red blood cell distribution width(RDW)and HDL-C(all P<0.05).Univariate and multivariate logistic analysis showed hemoglobin was an independent predictor of CAD in cases with positive ETT.The ROC curve for hemoglobin area under curve was 0.702(P<0.01).Using hemoglobin value≥137ng/L as a cut-point,the sensitivity and specificity for predicting CAD were 60.58%and 74.85%,respectively.Conclusion Hemoglobin level may influence the diagnostic value of positive ETT.