动态心电图与运动平板实验对缩窄性心包炎的诊断与评价

发布时间：2019-03-08 10:58

【摘要】：目的探究动态心电图与运动平板实验对结核性缩窄性心包炎以及心肌缺血的诊断价值;方法选择2016年1月至2017年2月在本院心内科治疗的疑似结核性缩窄性心包炎患者108例,每例患者均进行12导联动态心电图(DCG)、运动平板实验(TET)、超声心动图(UCG)、心肌血流灌注显象(MPI)、CT和心导管检查,分析对比DCG、TET以及两者联合检查分别对结核性缩窄性心包炎及心肌缺血诊断的敏感性、特异性、准确性和阳性预测率;结果确诊结核性缩窄性心包炎76例,联合检查的敏感性、特异性、准确性和阳性预测率均显著优于DCG和TET(P0.05),且TET均优于DCG,差异有统计学意义(P0.05)。经MPI确诊心肌缺血92例,联合检查的敏感性、特异性、准确性和阳性预测率均显著优于DCG和TET(P0.05),而DCG和TET比较差异没有统计学意义(P0.05);结论 DCG联合TET对结核性缩窄性心包炎及心肌缺血的诊断价值最高,其中TET诊断价值优于DCG,但针对存在TET检查禁忌症者,DCG同样具有较高的诊断价值。
[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.
【作者单位】：河北医科大学第二医院;
【基金】：河北省科技计划项目(项目编号:162777296)
【分类号】：R542.11

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