Préda I, Antalóczy Z, Balogh I, Szilvási I, Kozmann G, Rochlitz T, Pásztor F, Berentey E
Orvostovábbképzö Egyetem, Budapest, II. sz. Belgyógyászati Klinika.
Orv Hetil. 1991 May 12;132(19):1019-26.
A series of 137 patients suffered in clinically documented angina pectoris were analyzed by 12-lead exercise ECG, exercise body surface potential mapping and exercise thallium scintigraphic methods and the results were compared to that of selective coronary angiography and left ventriculography. If coronary artery stenosis were considered to be significant in the presence of more than 70% vessel narrowing, the sensitivity figures were 76, 93 and 88% for exercise 12-lead ECG, exercise body surface potential mapping and exercise thallium scintigraphy, respectively. In considering 50% coronary artery narrowing to be significant, the same figures were 78, 94 and 89%. Specificity figures at the same order were 59, 65 and 80% for more than 70%, and 64, 70 and 88% for more than 50% coronary obstructions. Exercise body surface potential mapping and exercise thallium scintigraphy applied parallelly gave a sensitivity of 100% and specificity of 53%. False-negative and false-positive exercise body surface potential mapping and thallium scintigraphic tests were analysed taking into consideration left ventricular function indices and respective patients. The authors suggest that the outstanding high sensitivity of the above mentioned two tests applied parallelly reveals that they highlights partially different aspects of coronary artery disease, and that is why the overlapping between the methods is relatively small. The majority of false-positive tests characterize a pathological state, and in these cases the exact diagnosis should be cleared up by other noninvasive/invasive methods.
对137例临床诊断为心绞痛的患者进行了12导联运动心电图、运动体表电位标测和运动铊闪烁显像检查，并将结果与选择性冠状动脉造影和左心室造影结果进行比较。如果在血管狭窄超过70%时认为冠状动脉狭窄具有显著性，运动12导联心电图、运动体表电位标测和运动铊闪烁显像的敏感性分别为76%、93%和88%。在认为50%的冠状动脉狭窄具有显著性时，相应的数字分别为78%、94%和89%。对于超过70%的冠状动脉阻塞，相应的特异性分别为59%、65%和80%；对于超过50%的冠状动脉阻塞，特异性分别为64%、70%和88%。同时应用运动体表电位标测和运动铊闪烁显像的敏感性为100%，特异性为53%。结合左心室功能指标和相关患者分析了运动体表电位标测和铊闪烁显像检查的假阴性和假阳性结果。作者认为，同时应用上述两项检查具有极高的敏感性，这表明它们突出了冠状动脉疾病的部分不同方面，这就是为什么这些方法之间的重叠相对较小。大多数假阳性检查表现为一种病理状态，在这些情况下，应通过其他非侵入性/侵入性方法明确准确诊断。
