| Objective: To study the relationship between multiple indexes of treadmill exercise test(TET)and myocardial ischemia in coronary heart disease(CHD),and to evaluate the diagnostic value of comprehensive index of treadmill exercise test in myocardial ischemia of coronary heart disease..Methods: A retrospective analysis of 464 patients with suspected coronary artery disease underwent treadmill exercise test and coronary angiography in the hospital for treadmill exercise test and within six months.Using the logistic regression method on the treadmill exercise test indexes and the risk factors of coronary heart disease were analyzed to find out the significance in the diagnosis of myocardial ischemia in coronary artery disease index by discriminant analysis method,these indicators to establish discriminant function,then using stepwise discriminant analysis method to verify the discriminant function.The differences between the discriminant function and the traditional positive index and ST segment depression in the diagnosis of myocardial ischemia were analyzed and compared.Results:(1)Sex,age,history of diabetes mellitus,△P,△QRS,△U,△R,△ST,△T,r SBP and symptoms of the diagnosis of myocardial ischemia was statistically significant.(P < 0.05).(2)the discriminant function equation of comprehensive index is: Y=-1.158X1+0.024X2+1.342X3+0.023X4+0.049X5-0.083X6+1.461X7-3.977X8+0.992X9+2.285X10+0.396X11-2.024.The correct rate of discrimination was 79.0%,and the correct rate of false negative group was 82.8%,and the total correct rate was about 81.5%.(3)The discriminant function of the new cases showed that the discriminant function of the positive rate was 67.0%,and the correct rate of the coronal negative group was 90.9%,and the total correct rate was about 82.4%.(4)the traditional discriminant function,positive index,single ST segment depression in the diagnosis of myocardial ischemia sensitivity 79%,69.1%,60.5%,specificity82.8%,61.9%,66.2%,accuracy of 81.5%,64.4%,64.4%,the positive predictive value of 71.1%,49.3%,49.0%,negative predictive value of 88.0%,78.9%,75.8%.(5)the discriminant function with traditional index and ST segment depression compared to the diagnosis of myocardial ischemia in patients with coronary heart disease sensitivity,specificity,positive predictive value was statistically significant(P < 0.05);negative predictive value was not statistically significant(P > 0.05).(6)compared with ST segment depression,the false positive rate was not statistically significant in the diagnosis of male patients with coronary heart disease(P < 0.05),and the false positive rate was statistically significant(P < 0.05).(7)there was no significant difference in the false negative rate between the discriminant function and ST segment depression in the diagnosis of single and three vessel lesions(P >0.05).The false negative rate of the diagnosis of double branch lesions was statistically significant(P < 0.05).Conclusion:(1)△P、△QRS、△U、△R、△ST、△T、r SBP and chest pain all had diagnostic significance for myocardial ischemia of coronary heart disease(CHD).(2)the comprehensive index can improve the sensitivity,specificity,accuracy and positive predictive value of treadmill exercise test in the diagnosis of coronary heart disease.(3)discriminant function can improve the sensitivity of treadmill exercise test in the diagnosis of coronary heart disease.(4)the discriminant function can reduce the rate of missed diagnosis of double vessel disease. |
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