摘要
目的 就性别对心率 (HR)调整心电图ST段降低方法诊断冠心病的影响进行探讨。方法 选取可疑冠心病患者共 173例 ,测定运动试验过程中心电图ST段变化值及ST/HR斜率和ST/HR指数 ,以冠状动脉 (冠脉 )造影结果作为诊断冠心病的标准。结果 ST/HR斜率和ST/HR指数诊断冠心病的敏感性、特异性均明显高于传统ST段指标 (P <0 0 5 )。ST/HR斜率和ST/HR指数诊断冠心病的敏感性男性患者分别提高 2 3%和 16 % ,女性患者分别提高 5 0 %和 4 2 % ,差异均有显著性意义 (P <0 0 5 ) ;而ST/HR斜率和ST/HR指数诊断冠心病的特异性 ,男性患者无明显提高 (P >0 0 5 ) ,女性患者分别提高 5 8%和 5 0 % (P <0 0 5 )。结论 ST/HR斜率和ST/HR指数与传统ST段指标相比 ,女性患者诊断冠心病的敏感性和特异性明显提高 ,男性患者敏感性有提高 。
Objective To assess the effects of gender on heart rate adjustment of ST segment depression(ST/HR) for identifying coronary arteriosclerotic disease.Methods One hundred and seventy three patients with suspe cted coronary disease (CAD) were referred for a routine treadmill exercise elect rocardiogram and subsequently they underwent selective coronary angiography with in 3 weeks. The magnitude of ST segment depression, ST/HR slope and calculated S T/HR index are performed by a computerized ECG system; exercise was performed according to the cornell protocol. CAD was defined by coronary angiography. We d ivided the patients into two groups by gender. Results Sensitivity and specificity for identifying CAD w ith ST/HR slope and ST/HR index were all significantly greater than that of stan dard electrocardiographic test criteria (P<0.05). Compared with standard cr iteria, the sensitivity for identifying CAD of ST/HR slope and ST/HRindex increased 23% and 16% in men , 50% and 42% in women respectively; all difference were statistically significant(P<0.05). The specificity for identifying CA D with ST/HR slope and ST/HR index increased 58% and 50% in women, with no incre ase in men. Conclusions It is suggested that sensitivity and specifi city for identifying CAD with ST/HR slope and ST/HRindex were all significa ntly higher than those with standard electrocardiographic test criteria in selec ted women patients. Sensitivity were significantly increased in selected men pat ients, with no significant change in specificity.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2004年第10期740-742,共3页
Chinese Journal of Internal Medicine
