| 摘要: |
| 目的 比较运动心电图（EXECG）与平板运动负荷超声造影试验对冠状动脉粥样硬化性心脏病(CAD)（以下简称冠心病）的诊断价值。方法 选取我院经冠状动脉血管造影检查(CAG)证实冠状动脉主要分支中至少有一支内径狭窄程度≥50%以上的冠心病患者120例，均行运动心电图和平板运动负荷超声造影检查，以冠状动脉血管造影结果为金标准，评价运动心电图和平板运动负荷超声造影两种检查方法诊断冠心病的敏感性、特异性和准确率。结果 运动心电图在冠状动脉主要分支中至少一支内径狭窄程度≥50%时，其诊断敏感性、特异性和准确率为58%、83%和72%；当狭窄程度≥75%时，其敏感性、特异性和准确率升高为63%、89%和79%，较狭窄程度≥50%有明显提升，具有差异有统计学意义（P＜0.05）。平板运动负荷超声造影在冠脉主要分支至少一支狭窄程度≥50%时，其诊断敏感性、特异性和准确率为77%、92%和85%，均高于运动心电图，差异均有统计学意义（均P＜0.05）；当狭窄程度≥75%时，敏感性、特异性和准确率升高为85%、96%和91%，亦同样高于运动心电图，差异均有统计学意义（均P＜0.05）。结论 平板运动负荷超声造影诊断冠心病较运动心电图具有更好的诊断效能，冠状动脉狭窄程度越高，其诊断敏感性和准确率越高。 |
| 关键词: 运动心电图 负荷超声造影 冠状动脉粥样硬化性心脏病 |
| DOI： |
| 投稿时间：2020-04-21修订日期：2021-07-01 |
| 基金项目: |
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| A comparative study of exercise electrocardiogram and treadmill exercise stress contrast-enhanced ultrasound in the diagnosis of coronary heart disease |
| xie wei,xi xian ping,zhao jin hua,zhang yuan xiang,wang ru |
| () |
| Abstract: |
| Objective A comparative research on diagnostic effects of the Exercise electrocardiography（EXECG） and contrast-enhanced ultrasound test for Coronary Artery Disease（CAD） will be carried out. Methods This paper takes 120 patients with coronary heart disease who are presently in stable condition and not taken any coronary stent implantation or coronary artery bypass graft as the research object.These patients are treated in our hospital between January 2018 and December 2019.Coronary angiography（CAG） verifies that at least one of the main branches（including anterior descending branch，circumflex branch，right coronary artery） of the coronary artery has fairly narrow microbores to the extent of more than 50%.Check this by EXECG and treadmill exercise stress contrast-enhanced ultrasound，and use CAG as the gold standard，to evaluate the sensitivity，specificity and accuracy of CAD diagnose by these two different ways. Results The sensitivity，specificity and accuracy of CAD diagnose by EXECG were 58%，83% and 72%，when microbores of at least one of the main branches of the coronary artery were narrower by 50%；when microbores were narrower by 75%，the sensitivity，specificity and accuracy would increase to 63%，89% and 79% respectively The degree of narrowness ≥50% has a significant increase, In the meantime，the statistical difference was revealed with P＜0.05；the sensitivity，specificity and accuracy were 77%，92% and 85% when the narrowness was more than 50%，which were higher than those of the EXECG treadmill with statistical difference of P＜0.05；when the narrowness was more than 75%，the sensitivity，specificity and accuracy increased to 85%，96% and 91%，which were also higher than those of the EXECG treadmill with statistical difference of P＜0.05.Conclusion The sensitivity，specificity and accuracy of the EXECG treadmill exercise in diagnosing ischemia of the coronary heart disease are lower than those of the treadmill exercise stress contrast-enhanced ultrasonography. The Treadmill exercise stress contrast-enhanced ultrasonography has a better diagnostic effect on the coronary heart disease.The higher the degree of the coronary stenosis is，the higher diagnostic sensitivity and accuracy of the Treadmill exercise stress contrast-enhanced ultrasonography will be. |
| Key words: Exercise electrocardiography Stress contrast-enhanced ultrasonography Coronary Artery Disease |
