食管心房调搏负荷试验联合平板运动试验对男性冠心病患者的诊断价值

目的 探讨食管心房调搏负荷试验联合平板运动试验对男性冠心病患者的诊断价值.方法 选择拟诊冠心病的男性患者82例,入选病例全部行冠状动脉造影,且造影前或后1个月行食管心房调搏负荷试验和平板运动试验,观察对比直径法确定的冠状动脉狭窄程度和范围与食管心房调搏负荷试验和平板运动试验结果.结果 以冠状动脉造影结果为标准,食管心房调搏负荷试验联合平板运动试验诊断冠心病的敏感度为72.9％,特异度为52.6％,阳性预测价值为90.4％,阴性预测价值为78.7％,食管心房调搏负荷试验及平板运动试验显示冠状动脉狭窄支数越多,ST段压低出现越早、压低程度越大、持续时间越长（P＜0.001）.冠状动脉造影阳性而食管心房调搏负荷试验、平板运动试验阴性者,多为单支病变或病变较轻.结论 简便易行且无创的食管心房调搏负荷试验联合平板运动试验能提高冠心病的诊断率,并可初步估测冠状动脉狭窄程度.

The diagnostic value of transesophageal atrial pacing stress test combined with treadmill exercise test in male patients with coronary heart disease

Objective To investigate the test combined with treadmill exercise test in diagnostic value of transesophageal atrial pacing stress male patients with coronary disease. Methods Eighty- two male patients with suspected coronary artery disease underwent coronary arteriography and transesophageal atrial pacing stress test combined with treadmill exercise test one month before or after coronary arteri was compared combined with ography. The degree and range of coronary artery stenosis assessed in diameter method between results of coronary arteriography and transesophageal atrial pacing stress test treadmill exercise test. Results With the result of coronary arteriography as a criterion, transesophageal atrial pacing stress test combined with treadmill exercise test had a sensitivity of 72.9% in diagnosing coronary disease, a specificity of 52.6%, a positive predictive rate of 90.4% and a negative predictive rate of 78.7%. It also revealed that in the combined method, the more the coronary artery stenosis leads were, the earlier ST segment depressions appeared with deeper depression degree and longer duration （P 〈 0. 001 ）. Patients with positive results of coronary arteriography and negative ones in the combined method were mostly single vessel diseased or slightly diseased. Conclusion The transesophageal atrial pacing stress test combined with treadmill exercise test is simple, easy to practice and noninvasive, which can increase the diagnostic rate of coronary disease and preliminarily estimate the degree of coronary artery stenosis.