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高頻心電圖、運(yùn)動平板在糖尿病患者中冠心病診斷價值的比較

發(fā)布時間:2018-05-31 09:32

  本文選題:高頻心電圖 + 運(yùn)動平板試驗(yàn) ; 參考:《石河子大學(xué)》2017年碩士論文


【摘要】:目的:1.探討高頻心電圖和運(yùn)動平板試驗(yàn)在糖尿病患者中冠心病的診斷價值。2.比較高頻心電圖和運(yùn)動平板試驗(yàn)在糖尿病患者中冠心病的診斷價值。3.比較高頻心電圖和運(yùn)動平板試驗(yàn)在糖尿病患者中檢出不同冠脈病變血管支數(shù)的陽性率。4.探討高頻心電圖和運(yùn)動平板試驗(yàn)聯(lián)合檢測在糖尿病患者中冠心病的診斷價值。方法:收集石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院2015年12月至2016年6月疑診冠心病的糖尿病患者138例,平均年齡54.22±8.47歲,其中男性81例,年齡38-75歲,平均年齡53.60±8.21歲,女性57例,年齡40-72歲,平均年齡55.09±8.83歲;同期行高頻心電圖、運(yùn)動平板試驗(yàn)和選擇性經(jīng)皮冠狀動脈造影檢查,以冠狀動脈造影結(jié)果(一支以上冠狀動脈狹窄≥50%)作為診斷冠心病的“金標(biāo)準(zhǔn)”,比較高頻心電圖和運(yùn)動平板試驗(yàn)在糖尿病患者中冠心病的診斷價值。皆在進(jìn)一步評估無創(chuàng)性檢查高頻心電圖和運(yùn)動平板試驗(yàn)診斷糖尿病患者冠心病中的價值及應(yīng)用前景。結(jié)果:1.高頻心電圖對糖尿病患者冠心病診斷的靈敏度是75.34%,特異度是89.23%,假陽性率是10.77%,假陰性率是24.66%,陽性預(yù)測值是88.71%,陰性預(yù)測值是76.32%,Youden指數(shù)是64.57%,正確率是81.88%。2.運(yùn)動平板試驗(yàn)對糖尿病患者冠心病診斷的靈敏度是63.01%,特異度是78.46%,假陽性率是21.54%,假陰性率是36.99%,陽性預(yù)測值是76.67%,陰性預(yù)測值是65.38%,Youden指數(shù)是41.47%,正確率是70.29%。3.隨著糖尿病患者冠脈病變支數(shù)的增加,高頻心電圖陽性率增加,差異有統(tǒng)計學(xué)意義(P0.05)。4.高頻心電圖和運(yùn)動平板試驗(yàn)對冠脈雙支及三支病變檢出的陽性率明顯高于對單支病變檢出的陽性率,差異有統(tǒng)計學(xué)意義(P0.05)。5.高頻心電圖和運(yùn)動平板試驗(yàn)進(jìn)行并聯(lián)試驗(yàn),可明顯提高糖尿病患者冠心病診斷的靈敏度,減少漏診率,可作為糖尿病患者早期診斷冠心病的篩查指標(biāo)。結(jié)論:1.高頻心電圖與運(yùn)動平板試驗(yàn)相比,對糖尿病患者冠心病的診斷有較高的靈敏度、特異度和預(yù)測準(zhǔn)確性,是糖尿病患者篩查冠心病的一種簡便和安全可靠的無創(chuàng)性檢查方法。2.高頻心電圖和運(yùn)動平板試驗(yàn)對冠脈雙支及三支病變的陽性檢出率明顯高于單支病變。3.高頻心電圖和運(yùn)動平板進(jìn)行并聯(lián)試驗(yàn)可提高糖尿病患者冠心病診斷的準(zhǔn)確性。
[Abstract]:Purpose 1. To investigate the diagnostic value of high frequency electrocardiogram (ECG) and treadmill exercise test in the diagnosis of coronary heart disease (CHD) in diabetic patients. To compare the diagnostic value of high frequency electrocardiogram (ECG) and treadmill exercise test in the diagnosis of coronary heart disease (CHD) in diabetic patients. Compare the positive rate of high frequency electrocardiogram (ECG) and exercise treadmill test in detecting vessel number of different coronary lesions in diabetic patients. 4. 4. To evaluate the diagnostic value of high-frequency electrocardiogram (ECG) combined with treadmill exercise test in the diagnosis of coronary heart disease (CHD) in diabetic patients. Methods: 138 diabetic patients with suspected coronary heart disease were collected from the first affiliated Hospital of Shihezi University Medical College from December 2015 to June 2016, with an average age of 54.22 鹵8.47 years, including 81 males aged 38-75 years, with an average age of 53.60 鹵8.21 years and 57 females. Age 40-72 years (mean 55.09 鹵8.83 years), high frequency electrocardiogram (ECG), treadmill exercise test and selective percutaneous coronary angiography (PCAG) were performed at the same time. The diagnostic value of high frequency electrocardiogram (ECG) and exercise treadmill test in the diagnosis of coronary heart disease (CHD) was compared with the results of coronary angiography (鈮,

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