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目的探讨活动平板运动试验假阳性相关影响因素,调整观察参数,提高心电图活动平板运动试验评估冠脉病变的价值。方法收集整理2012年1月至2014年6月因疑似冠心病在苏州九龙医院心脏中心接受活动平板运动试验、结果阳性的94例患者,所有患者均在平板运动试验后1w内行冠脉造影检查。根据造影结果将其分为真阳性组(A组)和假阳性组(B组),对比分析两组各项临床资料及活动平板试验数据。结果真阳性组和假阳性组在性别、最大运动耐量(Mets)、运动峰值、心率收缩压乘积方面有显著差异(p<0.05),A组平板运动试验中最大心率与运动终止后2 min心率的差值显著低于B组;A组平板运动试验终止后3 min收缩压与运动终止1 min收缩压的比值、包含2个以上冠心病危险因子的例数明显大于B组(p<0.05)。结论活动平板试验参数结合相关的临床资料、血流动力学相关参数,能提高冠脉病变的诊断准确性,对临床诊断冠心病、评估治疗效果和预后等方面可提供有价值的参考。
Objective To investigate the influencing factors of false positive of treadmill exercise test and to adjust the observation parameters to improve the value of treadmill exercise test in assessing coronary artery disease. Methods Ninety-four patients with suspected positive coronary heart disease who received active treadmill exercise at the heart center of Suzhou Kowloon Hospital from January 2012 to June 2014 were enrolled in the study. All patients underwent coronary angiography 1 week after the treadmill exercise test. According to the results of radiography, they were divided into true positive group (group A) and false positive group (group B). The clinical data and activity plate test data of two groups were compared and analyzed. Results There was a significant difference (p <0.05) between the true positive group and the false positive group in terms of gender, maximal exercise tolerance (Mets), exercise peak, and systolic blood pressure. The maximum heart rate in group A (P <0.05). The difference between systolic blood pressure and systolic blood pressure at 1 min after the end of treadmill exercise test in group A was significantly greater than that in group B (p <0.05) . Conclusion The combination of active plate test parameters and related clinical data and hemodynamic parameters can improve the diagnostic accuracy of coronary artery disease and provide valuable reference for clinical diagnosis of coronary heart disease, assessment of therapeutic effect and prognosis.