四种无创心电检查方法诊断冠心病的评价

目的　探讨普通心电图(ECG)、平板运动试验(TMT)、电话传输远程心电监测(TTM)、动态心电图(Holtermonitor)对冠心病(CHD)的诊断价值。方法　选择6 0例疑诊CHD的患者,将其ECG、TMT、TTM、Holter和冠状动脉造影(CA)检查结果进行对比分析,以CA为金标准计算以上四种无创心电检查方法的灵敏度、特异度等指标。结果　ECG、TMT、TTM、Holter的灵敏度分别为5 5 . 0 0 %、71 .4 3%、72 . 5 0 %、70 .0 0 % ;特异度分别为6 0 .0 0 %、76 .92 %、75 . 0 0 %、75 . 0 0 % ;准确度分别为5 6 .6 7%、74 . 0 7%、73. 33%、71. 88%。将TTM和TMT联合试验可使灵敏度提高到85 . 71% ,特异度提高到84 . 6 2 %。结论　ECG、TMT、TTM、Holter是诊断CHD的常用且重要的无创检查方法。

Value of four non-invasive electrocardiographic methods in the diagnosis of coronary heart disease

Objective To investigate the diagnostic value o f electrocardiography (ECG),treadmill test (TMT),transtelephonic monitoring (TTM ) and Holter monitor in coronary heart disease(CHD).Methods Six ty CHD patients diagnosed by coronary angiography (CA) were examined by ECG,TMT, TTM and Holter.The sensitivity,specificity and validity of them were compared an d analyzed.Results The sensitivity of ECG,TMT,TTM and Holter wa s 55 00%,71 43%,72 50%,70 00%;the specificity was 60 00%,76 92%,75 00%,7 5 00%;the validity was 56 67%,74 07%,73 33%,71 88%.A combined use of TMT a nd TTM improved the sensitivity up to 85 71% and the specificity up to 84 62%. Conclusion ECG,TMT,TTM and Holter are common and important non-i nvasive electrocardiographic methods for CHD.