平板运动试验诊断冠心病影响因素分析

目的：分析影响活动平板运动试验（TET）诊断冠心病准确性的因素。方法：选择115例2周内完成平板运动试验及冠状动脉造影（CAG）检查的临床拟诊冠心病患者,以冠状动脉造影结果为标准,将其分为平板运动试验真阳性和假阳性以及真阴性和假阴性组,对比分析这些患者的临床特征和与运动试验参数的关系。结果：TET检出冠心病的敏感性81.3%,特异性80.3%,准确度80%,假阳性率25%,假阴性率15.9%。女性假阳性率显著高于男性;真阳性组患者平均年龄较大,运动中发生心绞痛以及存在≥2个冠心病危险因子比例较高;运动当量、运动时间明显少于假阳性组（P〈0.05,〈0.01）,假阴性多见于单支冠脉病变（80%）。结论：活动平板运动试验结果受性别、患者所患基础疾病及冠状动脉病变程度等多种因素影响,了解活动平板运动试验假阳性和假阴性产生原因,结合临床特征、多种运动试验参数分析可提高诊断准确性。

Analysis of influence factors in treadmill exercise test for the diagnostic accuracy of coronary heart disease

Objective: To analyze the influence factors in treadmill exercise test for the diagnostic accuracy of coronary heart disease.Methods:115 case of suspicious CHD patient were tested by treadmill exercise test(TET) and coronary angiography(CAG) in two weeks,used the outcome of CAG as criteria,were divided into the groups of TET true-positive,false-positive and true-negative,false-negative,Applying their clinical characteristic and the exercise parameter.Results:The sensitivity of TET to diagnose CHD was 81.3%,the specificity 80.3%,the false positively rate was 25%,the false negative rate was 15.9%,the correct diagnosis rate 80%.The false positively rate in female were significantly higher than those in male.The age,the number of angina during test and 2 or greater risk factors in true-positive was higher,total exercise time and amount were significantly less than false-positive group(P<0.05).Single-branch coronary artery pathologic change was 80% in the false negative group.Conclusion:The results of TET are influenced by the sex,the disease,coronary artery pathologic change extent,and so on.Studying the reason of false-positive and false-negative,combined with clinical characteristic and the exercise parameter can improve the accuracy of diagnosis.