【摘要】：目的探究動(dòng)態(tài)心電圖與運(yùn)動(dòng)平板實(shí)驗(yàn)對(duì)結(jié)核性縮窄性心包炎以及心肌缺血的診斷價(jià)值;方法選擇2016年1月至2017年2月在本院心內(nèi)科治療的疑似結(jié)核性縮窄性心包炎患者108例,每例患者均進(jìn)行12導(dǎo)聯(lián)動(dòng)態(tài)心電圖(DCG)、運(yùn)動(dòng)平板實(shí)驗(yàn)(TET)、超聲心動(dòng)圖(UCG)、心肌血流灌注顯象(MPI)、CT和心導(dǎo)管檢查,分析對(duì)比DCG、TET以及兩者聯(lián)合檢查分別對(duì)結(jié)核性縮窄性心包炎及心肌缺血診斷的敏感性、特異性、準(zhǔn)確性和陽性預(yù)測(cè)率;結(jié)果確診結(jié)核性縮窄性心包炎76例,聯(lián)合檢查的敏感性、特異性、準(zhǔn)確性和陽性預(yù)測(cè)率均顯著優(yōu)于DCG和TET(P0.05),且TET均優(yōu)于DCG,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。經(jīng)MPI確診心肌缺血92例,聯(lián)合檢查的敏感性、特異性、準(zhǔn)確性和陽性預(yù)測(cè)率均顯著優(yōu)于DCG和TET(P0.05),而DCG和TET比較差異沒有統(tǒng)計(jì)學(xué)意義(P0.05);結(jié)論 DCG聯(lián)合TET對(duì)結(jié)核性縮窄性心包炎及心肌缺血的診斷價(jià)值最高,其中TET診斷價(jià)值優(yōu)于DCG,但針對(duì)存在TET檢查禁忌癥者,DCG同樣具有較高的診斷價(jià)值。
[Abstract]:Objective to explore the diagnostic value of dynamic electrocardiogram and treadmill test in tuberculous constrictive pericarditis and myocardial ischemia. Methods from January 2016 to February 2017, 108 patients with suspected tuberculous constrictive pericarditis who were treated in our hospital from January 2016 to February 2017 were selected. Each patient underwent 12 lead dynamic electrocardiogram (DCG),) exercise treadmill test with (TET), echocardiography (UCG),. Myocardial perfusion imaging (MPI), CT) and cardiac catheterization were performed. The sensitivity, specificity, accuracy and positive predictive rate of DCG,TET and their combined examinations in the diagnosis of tuberculous constrictive pericarditis and myocardial ischemia were analyzed and compared. Results in 76 cases of tuberculous constrictive pericarditis, the sensitivity, specificity, accuracy and positive predictive rate of combined examination were significantly better than those of DCG and TET (P0.05), and the difference between TET and DCG, was statistically significant (P0.05). In 92 cases of myocardial ischemia diagnosed by MPI, the sensitivity, specificity, accuracy and positive predictive rate of combined examination were significantly better than those of DCG and TET (P0.05), but there was no significant difference between DCG and TET (P0.05). Conclusion DCG combined with TET has the highest diagnostic value in tuberculous constrictive pericarditis and myocardial ischemia. TET is superior to DCG, in the diagnosis of tuberculous constrictive pericarditis and myocardial ischemia, but DCG has high diagnostic value in patients with TET contraindications.
【作者單位】： 河北醫(yī)科大學(xué)第二醫(yī)院;
【基金】：河北省科技計(jì)劃項(xiàng)目(項(xiàng)目編號(hào):162777296)
【分類號(hào)】：R542.11

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