24 h动态心电图联合运动平板试验对隐匿型冠状动脉粥样硬化性心脏病患者诊断效能的影响

目的分析24 h动态心电图+运动平板试验(treadmill exercise test,TET)对隐匿型冠状动脉粥样硬化性心脏病(冠心病)患者诊断效能的影响。方法选取我院收治的80例隐匿型冠心病的患者为研究对象,分别进行24 h动态心电图、TET试验及联合24 h动态心电图与TET试验检查,分析患者的检查结果,分析检查的灵敏性、特异性、阳性预测值及阴性预测值。结果以冠状动脉造影为金标准,24 h动态心电图确诊阳性41例,阴性18例。TET试验确诊阳性42例,阴性16例。24 h动态心电图+TET试验检查确诊阳性50例,阴性24例。24 h动态心电图+TET试验检查较单一24 h动态心电图检查、TET试验检查,灵敏度更高,特异度更高,阳性预测值更准确,阴性预测值更准确,差异均有统计学意义(P<0.05)。结论24 h动态心电图+TET试验检查有效提高对隐匿性冠心病患者的诊断效能,提高灵敏度、特异度,减少假阳性、假阴性发生。

Effect of 24h dynamic electrocardiogram combined with TET test on diagnostic efficacy of patients with occult coronary heart disease

Objective To analyze the effect of 24 h dynamic electrocardiogram combined with treadmill exercise test(TET)on the diagnostic efficacy of patients with occult coronary heart disease.Methods Eighty patients with occult coronary heart disease admitted to our hospital were enrolled in the study.The 24 h dynamic electrocardiogram,TET test and 24h dynamic electrocardiogram and TET test were performed to analyze the patient′s test results,sensitivity,specificity,positive predictive value,and negative predictive value.Results With coronary angiography as gold standard forty-one cases were positive for 24 h dynamic electrocardiogram and 18 cases were negative.The TET test confirmed 42 cases positive and 16 cases negative.The 24 h dynamic electrocardiogram combined with TET test confirmed 50 cases were positive and 24 cases were negative.Compared with the 24 h dynamic electrocardiogram and TET test,the 24 h dynamic electrocardiogram combined with TET test showed higher sensitivity,higher specificity,more accurate positive predictive value,and more accurate negative predictive value.The difference was statistically significant(P<0.05).Conclusion 24 h dynamic electrocardiogram combined with TET test can effectively improve the diagnostic efficiency of patients with occult coronary heart disease,improve sensitivity,specificity,and reduce false positives and false negatives.