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目的评价运动平板试验(treadmill exercise ECG testing,TET)对CohnⅠ型无症状心肌缺血(slient myo-cardial ischemia,SMI)的诊断价值。方法对经动态心电图检查拟诊的145例CohnⅠ型SMI进行TET及冠状动脉造影(CAG)检查,观察敏感性、特异性、准确性、阳性及阴性预测值。结果 TET诊断CohnⅠ型SMI的敏感性为89.3%,特异性为67.2%,准确性为80.0%,阳性预测值为78.9%,阴性预测值为82.0%;多支冠状动脉病变TET阳性率与单支病变比较差异无统计学意义(P>0.05)。合并有≥2个危险因素组TET检查敏感性和准确性均高于无/1个危险因素组,差异有统计学意义(P<0.01)。女性TET假阳性率高于男性,差异有统计学意义(P<0.01)。结论 TET对CohnⅠ型SMI的特异性较低,但敏感性较高,与SMI的危险因素相结合,能明显提高诊断的准确性,降低假阳性率。
Objective To evaluate the diagnostic value of treadmill exercise ECG testing (TET) for Cohn type I silent myo-cardial ischemia (SMI). Methods Tot and coronary angiography (CAG) were performed on 145 Cohn Ⅰ SMIs diagnosed by Holter examination. Sensitivity, specificity, accuracy, positive and negative predictive value were observed. Results The sensitivity, specificity and accuracy of TET in diagnosing Cohn type I SMI were 89.3%, 67.2%, 80.0%, 78.9%, and 82.0%, respectively. The positive rate of TET in multiple coronary artery lesions was significantly higher than that in single branch No significant difference in lesions (P> 0.05). The sensitivity and accuracy of TET with ≥2 risk factors were higher than those without / 1 risk factors, the difference was statistically significant (P <0.01). The false positive rate of TET in females was higher than that in males (P <0.01). Conclusions TET is less specific, but more sensitive to Cohn type I SMI. Combined with the risk factors of SMI, TET can significantly improve the diagnostic accuracy and reduce the false positive rate.