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目的分析在胸痛患者中运动平板试验阳性对冠心病的诊断符合率。比较男性组、女性绝经前组、绝经后组运动平板假阳性率的差异。方法运动平板试验均采用Bruce方案,使用美国GE公司CardioSys-CE-0459运动平板机。对268例临床有胸痛症状的运动平板试验阳性患者行冠状动脉(冠脉)造影检查,冠脉狭窄≥50%诊断为冠心病。以冠脉造影结果为金标准,比较男性组(146例)、女性绝经期前组(39例)及绝经期后组(83例)运动平板试验的假阳性率。结果冠脉造影确诊冠心病176例(65.67%),其中男性105例,女性71例;冠脉造影阴性者92例(34.33%),男性41例,女性51例。女性绝经后组〔30.12%(25/83)〕与男性组〔28.08%(41/146)〕比较,运动平板的假阳性率差异无统计学意义(χ2=0.107,P=0.428),绝经前组〔66.67%(26/39)〕与男性组(28.08%)及绝经后组(30.12%)比较差异均有统计学意义(χ2=19.83,P=0.000;χ2=14.57,P=0.000)。结论胸痛患者在冠脉造影前行运动平板试验筛查,阳性者再行冠脉造影可大大提高冠脉造影检查的阳性率。与绝经后组及男性组比较,绝经期前女性运动平板试验假阳性率较高,绝经后女性与男性无明显差异。
Objective To analyze the diagnostic accuracy of treadmill test in coronary heart disease in patients with chest pain. Comparison of male group, female premenopausal group, menopausal group motor flat false positive rate differences. Methods All treadmill tests were performed using the Bruce protocol, using a GE Healthcare CardioSys-CE-0459 motion plate. 268 cases of clinical symptoms of chest pain test positive patients underwent coronary artery (coronary) angiography, coronary stenosis ≥ 50% diagnosis of coronary heart disease. Taking the coronary angiography as the gold standard, the false positive rate of treadmill test was compared between male group (146 cases), female premenopausal group (39 cases) and postmenopausal group (83 cases). Results Coronary angiography confirmed coronary heart disease in 176 cases (65.67%), including 105 males and 71 females; coronary angiography negative in 92 cases (34.33%), 41 males and 51 females. There was no significant difference in the false positive rates of motor plates between the menopausal group [30.12% (25/83)] and the male group (28.08%, 41/146) (χ2 = 0.107, P = 0.428) Group (66.67%, 26/39) was significantly different from male group (28.08%) and postmenopausal group (30.12%) (χ2 = 19.83, P = 0.000; χ2 = 14.57, P = 0.000). Conclusions Chest pain patients should be screened by treadmill exercise test before coronary angiography. Correct coronary angiography may improve the positive rate of coronary angiography. Compared with the menopausal group and the male group, the pre-menopausal women had higher false positive rate of motor treadmill test, and no significant difference between men and women after menopause.