CAJ | 학술논문

目的总结平板运动试验诱发缺血性T波对冠心病的诊断价值。方法回顾性总结分析住院接受活动平板运动试验（TET）及冠状动脉造影（CAG）检查患者445例平板运动试验诱发缺血性T波对冠心病的诊断价值。结果①445例中， TET阳性200例，其中CAG阳性150例，CAG阴性50例；TET阴性245例，其中CAG阴性206例，CAG阳性39例。TET检出冠心病的敏感性为79.36%（150/189），特异性为80.47%（206/256）。②T波正常化组和运动试验阳性组间冠状动脉造影阳性无统计学意义（P＞0.05）；运动试验阴性组与T波正常化组、运动试验阳性组冠状动脉造影阳性结果比较，有统计学意义（P＜0.05）。结论平板运动试验诱发的缺血性T波（T波正常化）作为运动试验阳性的新指标。
목적총결평판운동시험유발결혈성T파대관심병적진단개치。방법회고성총결분석주원접수활동평판운동시험（TET）급관상동맥조영（CAG）검사환자445례평판운동시험유발결혈성T파대관심병적진단개치。결과①445례중， TET양성200례，기중CAG양성150례，CAG음성50례；TET음성245례，기중CAG음성206례，CAG양성39례。TET검출관심병적민감성위79.36%（150/189），특이성위80.47%（206/256）。②T파정상화조화운동시험양성조간관상동맥조영양성무통계학의의（P＞0.05）；운동시험음성조여T파정상화조、운동시험양성조관상동맥조영양성결과비교，유통계학의의（P＜0.05）。결론평판운동시험유발적결혈성T파（T파정상화）작위운동시험양성적신지표。
[Abstract ]Objective To determine the diagnostic value of treadmill exercise test(TET)in patients with coronary heart disease (CHD)by comparing the diagnostic conclusion with coronary angiography(CAG).Methods 445 patients with coronary heart disease(CHD)and suspected CHD underwent treadmill exercise test and coronary angiography (CAG), and the diagnostic conclusions were compared.Results ①The 200 cases had the positive result during treadmill exercise test and 150cases hand been diagnosed CHD by coronary angiography; The 245 cases had the negative result during treadmill exercise test and 39cases hand been diagnosed CHD by coronary angiography. The sensitivity, specificity, positive predictive value, negative predictive value, the false positive incidence, the false negative incidence and agreement rate in diagnosis of CHD by treadmill exercise test were 79.36%, 80.40%, 75.00% , 84.08%, 25.00%, 15.92% and 80.00%, respectively. The patients with multi-vessel diseased had a higher positive rate of TET as compared with those with single diseased vessel(P<0.05). ②chest leads positive rate was more than that of limb leads(P<0.05). (3)R wave amplitude after exercise to reduce with normal coronary artery. But, with significant stenosis of coronary, R wave amplitude after exercise to increase. (4) There were no statistically significant between T wave normalization group and TET positive group(P>0.05). But, there were statistically significant among TET negative group ,T wave normalization group and TET positive group (P<0.05).Conclusions The treadmill exercise test is valuable in noninvasive diagnosis of CHD, especially for patients with multi-vessel diseased. Ischemic T-wave’s changes in the comprehensive exercise testing can be initially estimated the severity, T wave normalization can be as a new positive indicators of exercise test.