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目的评价单独或联合应用12导联动态心电图与平板运动试验对冠心病的诊断价值。方法选择35例疑诊冠心病的患者,2周内分别行12导联动态心电图及平板运动试验检查,并于其后1周内完成冠脉造影检查,对运动试验、动态心电图及冠脉造影结果进行分析。结果联合应用12导联动态心电图与平板运动试验在检出缺血性ST段改变和诊断冠心病的敏感性、特异性等各项指标间无显著性差异(p>0.05);两项均有和均无缺血性ST段改变(均阳性或均阴性)与单用运动试验或12导联动态心电图比较,虽敏感性、特异性、符合率等有所提高,但亦无显著性差异(p>0.05)。结论联合应用12导联动态心电图与平板运动试验诊断冠心病价值与单独应用其中一项并无明显优势,可视患者具体情况选择其中一种,并对ST段改变的临床意义进行综合分析。
Objective To evaluate the diagnostic value of 12-lead Holter test and treadmill exercise test in patients with coronary heart disease (CHD) alone or in combination. Methods 35 patients with suspected coronary artery disease were selected. Within 12 weeks, 12-lead ambulatory electrocardiogram and treadmill exercise test were performed. Coronary angiography was performed within 1 week after exercise. Motor test, ambulatory electrocardiogram and coronary angiography Results were analyzed. Results The combination of 12-lead Holter and treadmill exercise test showed no significant difference (p> 0.05) between the detection of ischemic ST segment changes and the sensitivity and specificity of diagnosis of coronary heart disease (p> 0.05) And no ischemic ST segment changes (both positive or negative) compared with single exercise test or 12-lead ambulatory ECG, although the sensitivity, specificity, coincidence rate increased, but there was no significant difference p> 0.05). Conclusion The combination of 12-lead Holter monitoring and treadmill exercise test in the diagnosis of coronary heart disease has no obvious advantage compared with either alone. One of them can be selected according to the specific conditions of patients and the clinical significance of ST segment changes can be analyzed comprehensively.