运动试验多变量分析诊断冠心病的评价

目的：探讨运动试验多变量分析对冠心病的预测价值。方法：选择451例住院病人，在同期都做选择性冠状动脉造影和运动试验（两种检查的平均间隔时间为7d)，选择性冠状动脉造影采用Judkins法，以冠脉直径狭窄≥50％作为诊断冠心病的标准，心电图运动试验采用次极量踏车运动试验。统计处理采用SPSS 8．0for Windows软件包，结果：运动试验检出冠心病的敏感性与特异性分别为80．13％及68．18％，运动时间，ST段下移动量，收缩压差，ST段压低持续时间与冠脉病变的存在及严重程度有统计学意义（P＜0．001），而舒张压差，年龄，功量3项变量被排除（其P值均＞0．05），结论：利用心电图运动试验诊断冠心病简单易行，并对冠脉病变范围及严重程度有一定诊断价值。但需结合多参数分析以增加准确性及灵敏性。

Multivariate Analysis Improves Diagnostic Accuracy of Treadmill Exercise Test for Conorary Heart Disease

Aim: To evaluate diagnostic accuracy of multivariate analysis of treadmill exercise test(TET) in conorary heart disease(CHD). Methods: 451 patients with CHD, defined as the presence of one or more vessels with 50% luminal diameter narrow, were underwent selected coronary angiography and sub-maximal TET. SPSS 8.0 for windows was used for statistics. Results:TET identified patients with CHD with a sensitivity of 80.13%,specificity of 68.18%.Exercise time,work of ST segment depression,difference of systolic pressure and duration of ST segment depression were associated with the presence and extent of CHD(P<0.001). But ages, defference of diastolic pressure and work were not(P>0.05). Conclusions: TET combining multivariate analysis is a useful method to value of pathological change area and seriousness of coronary arteria.