冠心病无创性检查与冠状动脉造影的诊断价值比较

为探讨无创性检查对不同冠心病的诊断价值,在接受选择性冠状动脉造影的639例住院患者中,对常规心电图(ECG)、运动试验(TET)、动态心电图(Holter)3种无创性检查进行冠心病诊断价值的分析比较.结果发现3种检查方法中ECG敏感性最高,达77.2％(P＝0.001),TET最低,为62.5％(P＝0.013).特异性最高为TET,达63.5％,Holter最低,为49.7％.ECG、TET及Holter对冠状动脉狭窄检出率随病变支数的增多而增高.研究认为常规ECG可作为冠心病筛选检查的首选方法;TET的诊断价值最高,尤其是对无症状性心肌缺血,更具有实用价值;Holter的敏感性及特异性与ECG相似,用于发现院外及日常生活中的心肌缺血,是其他检查方法无法替代的.

Non-invasive approaches ECG, treadmill exercise test and Holter comparing with coronary angiography in diagnosis of coronary artery disease

This paper is to compare the value of ECG, treadmill exercise test(TET) and Holier in the diagnosis of coronary artery disease. Totally 639 patients with coronary artery disease confirmed by coronary angiography were included. The results showed that the sensitivity of ECG was 77.2%, TET 62.5% and Holter 71.1%. The specificity of ECG was 50%, TET 63.5% and Holter 49.7%.It is suggested that ECG is the first chioce for the screening of coronary heart diseases. TET is most valuable in the diagnosis of coronary artery disease, specially for asymptomatic cardiac eschemia; Holter is an important method to examine the patient with coronary heart disease outside hospital,which cannot be substitute by other methods.