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105名看似健康男性的假阳性诊断测试及冠状动脉造影结果

False positive diagnostic tests and coronary angiographic findings in 105 presumably healthy males.

作者信息

Erikssen J, Enge I, Forfang K, Storstein O

出版信息

Circulation. 1976 Sep;54(3):371-6. doi: 10.1161/01.cir.54.3.371.

Abstract

Among 2014 presumably healthy males aged 40-59 years coronary heart disease (CHD) was suggested in 115 in the presence of one or more of the following criteria: 1) a WHO-questionnaire on angina pectoris positive on interview, 2) typical angina during a near maximal bicycle exercise test, 3) a positive exercise ECG during and/or post exercise, 4) a Minnesota Code 1.1 on a resting ECG. Diagnostic coronary angiography was offered to all 115 CHD-suspect cases. Six refused angiography and four others were excluded. Of the remaining 105, thirty-six had less than 50% obstruction of any major coronary artery (34.3%). Eighteen (17.1%) had single, 25 (23.8%) had double and 26 (24.8%) had triple vessel disease. In 62 of the 69 with pathologic angiograms at least one obstruction greater than or equal to 75% was found. Eighty percent of the cases with proven CHD were greater than or equal to 50 years. All CHD-suggestive criteria had approximately the same diagnostic performance regardless of age, i.e., approximately one false positive/two true positives. Except for one retroperitoneal hematoma no complications to angiography occurred.

摘要

在2014名年龄在40至59岁之间的健康男性中,有115人存在以下一项或多项标准,提示患有冠心病(CHD):1)世界卫生组织(WHO)关于心绞痛的问卷调查在访谈时呈阳性;2)在接近最大运动量的自行车运动试验中出现典型心绞痛;3)运动期间和/或运动后运动心电图呈阳性;4)静息心电图上有明尼苏达编码1.1。对所有115例疑似冠心病病例均进行了诊断性冠状动脉造影。6人拒绝造影,另有4人被排除。其余105例中,36例任何主要冠状动脉阻塞小于50%(34.3%)。18例(17.1%)为单支血管病变,25例(23.8%)为双支血管病变,26例(24.8%)为三支血管病变。在69例血管造影病理检查的病例中,62例发现至少一处阻塞大于或等于75%。经证实患有冠心病的病例中,80%年龄大于或等于50岁。无论年龄大小,所有提示冠心病的标准诊断性能大致相同,即大约1例假阳性/2例真阳性。除1例腹膜后血肿外,未发生冠状动脉造影并发症。

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