活动平板运动试验和心电图在冠心病中的诊断价值

目的探讨活动平板运动试验（TMT）及心电图（ECG）动诊冠心病的价值。方法从1993年5月～1996年12月做冠脉造影（CAG）、TMT和ECG的可疑冠心病者中随机抽取35例，以CAG为标准计算TMT和ECG的敏感性等指标，分析TMT和ECG的助诊效果。结果可疑患者最小23岁，随年龄而增加，40岁后尤明显，CAG显示40岁前实际患者很少，其后明显增加。冠脉狭窄累及前降支者最多。TMT的敏感性、阴性结果预测值均较ECG高。冠脉狭窄大于75％者TMT及ECG均呈阳性，在4O％～75％者TMT多呈阳性而ECG均呈阴性。结论TMT助诊冠心病较ECG更敏感，但需排除假阳性。

Diagnostic evaluation treadmill test and electrocardiogram in coronary heart disease

To determine the diagnostic value of treadmill test (TMT) and electrocardiogram (ECG) in coronary heart disease (CHD).Methods Cases were randomly sampled from the patients diagnosed clinically as CHD and checked by TMT,ECG and CAG from May 1993to Dec. 1996. Indexes of TMT and ECG such as the sensitivity were calculated by CAG standards.The value of TMT and ECG from detected myocardial ischimia was analysed in some aspects.Results The youngest case diagnosed clinically as CHD was 23 years old. As age grew,the patients with clinical CHD increased especially in over 40 years old. The CHD patients identified by CAG under 40 years old were few but more obviously over 40 years old. Coronary artery stenosis mostly located in anterior desending artery by CAG. The sensitivity and the predictive values of negative in TMT were higher than those in ECG.When coronary artery stenosis was over 75%,there were all positive results in TMT and ECG.While the coronary artery stenosis in 40 % ~ 75 %,there were 3 positive in 4 cases by TMT but none by ECG.Conclusion TMT was a more sensitive noninvasic examination for CHD than ECG. When CHD was diagnosed by TMT, the false positive cases should be eliminated.