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目的探讨平板运动试验联合冠心病高危因素对冠心病的诊断的价值。方法选择128例进行平板运动试验的患者,同期观察血压、进行血脂及冠状动脉动脉造影检查。统计患者血压、血脂异常发生率,比较单纯进行平板运动试验(单纯组)及平板运动试验联合高危因素(联合组)诊断冠心病的灵敏性,特异性。结果 1128例患者经冠脉造影确诊冠心病为106例,其中血脂,血压异常者98例,正常者18例,血脂,血压异常的患者明显高于正常患者(P<0.05),有统计学意义,非冠心病为22例。2单纯组诊断冠心病的阳性预测值为71.13%,阴性预测值为67.74%,灵敏性为88.68%,特异性为72.73%,联合组诊断冠心病的阳性预测值为90.99%,阴性预测值为88.25%,灵敏性为93.88%,特异性为87.5%,联合组诊断冠心病的阳性预测值,阴性预测值,特异性,灵敏性明显优于单纯组(P<0.05),有统计学意义。结论平板运动试验联合冠心病高危因素可明显提高冠心病患者的阳性预测价值,对于冠心病的诊断具有重要的临床意义。
Objective To investigate the value of treadmill exercise test combined with risk factors of coronary heart disease in the diagnosis of coronary heart disease. Methods A total of 128 patients undergoing treadmill exercise test were selected. Blood pressure was observed during the same period, and lipids and coronary artery angiography were performed. Statistics of patients with blood pressure, the incidence of dyslipidemia, simple comparison of treadmill exercise test (simple group) and treadmill exercise test combined with risk factors (combination group) to diagnose the sensitivity and specificity of coronary heart disease. Results Coronary heart disease was diagnosed in 106 patients by coronary angiography in 1128 patients. Among them, 98 cases of dyslipidemia and abnormal blood pressure, 18 cases of normal blood pressure and abnormal blood pressure were significantly higher than those of normal patients (P <0.05) , Non-coronary heart disease in 22 cases. In the simple group, the positive predictive value of CHD was 71.13%, the negative predictive value was 67.74%, the sensitivity was 88.68% and the specificity was 72.73%. The positive predictive value of coronary heart disease in the combined group was 90.99%, the negative predictive value was 88.25%, 93.88% sensitivity and 87.5% specificity. The positive predictive value, negative predictive value, specificity and sensitivity in the diagnosis of coronary heart disease in the combined group were significantly better than those in the simple group (P <0.05). Conclusion The treadmill exercise test combined with the risk factors of coronary heart disease can significantly improve the positive predictive value of coronary heart disease patients and has important clinical significance for the diagnosis of coronary heart disease.