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[运动心电图作为冠心病早期诊断的筛查试验。一项试验研究的结果(作者译)]

[Exercise ECG as a screening test in the early diagnosis of coronary heart disease. Result of a trial study (author's transl)].

作者信息

Wollenweber J, Christl H L, Hausen W, Rau G

出版信息

Dtsch Med Wochenschr. 1978 Apr 21;103(16):688-94. doi: 10.1055/s-0028-1104501.

Abstract

1500 men (aged 30-55 years) volunteered in a trial of early recognition of cardiovascular disease. History and clinical as well as biochemical data were obtained and compared with results of exercise ECGs. In the group as a whole abnormal ECGs were obtained in 6.2%, in a subgroup of those without exercise-dependent pain in the thorax, without hypertension and noraml resting ECG it was 3.8%, while in the presence of one or several of these risk factors it was as high as 17.8%. It is concluded that in any screening programme it is not reasonable to perform exercise ECGs in asymptomatic persons without risk factors, because in this group there is likely to be only a small percentage of abnormal findings and the number of false-positive ones is higher than that or correct positive ones. In connection with the known risk factors and risk indicators it would be best to define the risk group and, using selective indications, to go step-by-step from exercise ECG to additional invasive diagnostic measures such as coronary angiography.

摘要

1500名年龄在30至55岁之间的男性自愿参与了一项心血管疾病早期识别试验。收集了病史、临床及生化数据,并与运动心电图结果进行比较。在整个组中,异常心电图的比例为6.2%;在无运动相关性胸痛、无高血压且静息心电图正常的亚组中,这一比例为3.8%;而在存在一项或多项这些危险因素的人群中,该比例高达17.8%。得出的结论是,在任何筛查项目中,对无危险因素的无症状人群进行运动心电图检查是不合理的,因为在这组人群中,异常发现的比例可能很小,且假阳性的数量高于真阳性。结合已知的危险因素和风险指标,最好确定风险组,并根据选择性指征,逐步从运动心电图过渡到额外的侵入性诊断措施,如冠状动脉造影。

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