平板运动试验、运动及潘生丁负荷心肌断层显像对冠心病诊断的评价

目的 :评价亚极量平板运动试验 (TET)、运动负荷心肌断层 (SPECT)显像及潘生丁负荷心肌SPECT显像对冠心病 (CAD)的诊断价值。方法 :以冠状动脉造影 (CAG)为标准 ,83例做过CAG的患者被分为CAD组 (n =37)和非CAD组 (n =4 6 )。所有患者均行TET ,5 6例患者行运动负荷心肌SPECT显像 ,2 7例患者行潘生丁负荷心肌SPECT显像。对比分析TET、运动及潘生丁负荷心肌SPECT显像诊断CAD的灵敏度、特异性、准确性、阳性预测值、阴性预测值。结果 :TET、运动及潘生丁负荷心肌SPECT显像诊断CAD的灵敏度分别为 5 1.4 %、95 .5 %、93.3% ;特异性分别为 76 .1%、88.2 %、91.7% ;准确性分别为 6 5 .1%、91.1%、92 .6 % ;阳性预测值分别为 6 3.3%、84 .0 %、93.3% ;阴性预测值分别为 6 6 .0 %、96 .8%、71.7%。结论 :运动负荷心肌SPECT显像与潘生丁负荷心肌SPECT显像对CAD的诊断价值相近 ,且均优于TET。

The Comparison of the Diagnostic Values of Treadmill Exercise Testing, Exercise and Dipyridamole Stress SPECT Myocardial Perfusion Imaging in Coronary Artery Disease

Objective To compare the diagnostic values of treadmill exercise testing(TET), exercise stress SPECT myocardial perfusion imaging(MPI) and dipyridamole stress SPECT MPI in coronary artery disease(CAD).Methods Eighty three suspected CAD patients who had undergone coronary angiography (CAG) were divided into two groups according to the CAG results, the group of CAD(n=37) and the group of Non-CAD(n=46).All patients underwent TET, fifty six patients exercise stress SPECT MPI,and twenty seven patients dipyridamole stress SPECT MPI. Then the sensitivity,specificity, accuracy, positive/negative predictive value of TET, exercise stress SPECT MPI and dipyridamole stress SPECT MPI in diagnosing CAD were compared.Results The sensitivity values of TET, exercise and dipyridamole stress SPECT MPI are 51.4 %,95.5 %,93.3 % respectively;those of specificity are 76.1 %、88.2 %、91.7 % respectively;those of accuracy are 65.1 %、91.1 %、92.6 % respectively;The positive predictive values are 63.3 %、84.0 %、93.3 % respectively and the negative predictive values are 66.0 %、96.8 %、71.7 % respectively.Conclusions The value of exercise stress SPECT MPI is similar to that of dipyridamole stress SPECT MPI in diagnosing CAD, both of which are better than TET.