van der Watt F J, Nel C J, Jordaan P J, Otto A C, Travers A M
Department of Surgery, Universitas Hospital, Bloemfontein.
S Afr Med J. 1990 Sep 1;78(5):232-5.
ECG-monitored exercise testing has been proposed as a relatively inexpensive and effective means of screening for asymptomatic coronary artery disease in patients presenting for peripheral vascular surgery. Despite the fact that exercise thallium scintigraphy is also dependent on the patient's ability to exercise, using this test in conjunction with ECG-monitored exercise testing may enhance sensitivity and specificity of non-invasive evaluation. Thirty-two patients were subjected to ECG-monitored exercise testing, exercise thallium scintigraphy and coronary angiography. The sensitivity of ECG-monitored exercise testing for detecting coronary artery disease was calculated at 81.8% and the specificity at 87.5%, while the figures for exercise thallium scintigraphy were 73.1% and 33.3% respectively. Using these two methods in combination yielded a predictive accuracy of 90.6%. The only advantage of exercise thallium scintigraphy over exercise ECG appears to be in patients in whom the latter test could not be interpreted or was non-diagnostic.
有人提出，对于接受外周血管手术的患者，心电图监测运动试验是一种相对廉价且有效的无症状冠状动脉疾病筛查方法。尽管运动铊闪烁扫描也取决于患者的运动能力，但将该检查与心电图监测运动试验结合使用可能会提高无创评估的敏感性和特异性。32例患者接受了心电图监测运动试验、运动铊闪烁扫描和冠状动脉造影。心电图监测运动试验检测冠状动脉疾病的敏感性计算为81.8%，特异性为87.5%，而运动铊闪烁扫描的相应数字分别为73.1%和33.3%。将这两种方法结合使用可产生90.6%的预测准确率。运动铊闪烁扫描相对于运动心电图的唯一优势似乎在于那些无法解释后者检查结果或后者检查无诊断意义的患者。
