| Objective The qualitative results of routine Treadmill exercise test is certainly valuable in the diagnosis of cardiovascular disease,but there are also some limitations.This study uses treadmill exercise test metabolic equivalent combined with Duke score to evaluate ischemic heart disease,and explores the improvement of Duke score combined with metabolic equivalent to discuss the correlation of the diagnostic value on coronary heart disease as a prediction of CHD and the evaluation of the degree on coronary artery disease.Methods A randomized collection of 272 patients with CHD in Baotou Central Hospital from January 2019 to January 2020.On the basis of Coronary Angiography or CT results,the patients were divided into case group and control group,and the physiological and biochemical indicators of the case group and the control group were compared to see whether there is a difference between the groups;meanwhile,multivariate logistic regression analysis was performed on the case group to observe whether the metabolic equivalent combined with the Duke score can increase the predictive value of CHD.Result Multivariate logistic regression analysis was performed on the selected 154 patients with CHD and its results showed that age,hypertension history,metabolic equivalent,Duke score,and Gensini score were independent influencing factors of CHD(P<0.05).Among them,age,hypertension history and Gensini score are independent risk factors(OR>1),metabolic equivalent and Duke score are protective factors(OR<1),the regression equation Y(combined index)= 8.556-0.366*metabolic equivalent-0.883*Duke score2.Metabolic equivalent and Duke score are positively correlated,the correlation coefficient r=0.587,P value <0.001;3.Metabolic equivalent and Gensini score have a certain negative correlation,correlation coefficient r=-0.440,P value <0.05;4.Duke score and Gensini score are highly negatively correlated,the correlation coefficient r=-0.754,P value <0.05;5.The metabolic equivalent level of patients in the case group(6.28±1.08METs)is lower than the metabolic equivalent level of the control group(7.39±1.29 METs),the difference between the two was statistically significant(P<0.001);6.The Duke score of patients in the case group(5.38±1.65)was lower than the Duke score of the control group(7.80±1.70),and the difference between the two was statistically significant(P <0.001);7.Detect the metabolic equivalent and Duke score levels of these two groups of patients,analyze their correlation with coronary heart disease,use receiver operating characteristic curve(ROC curve),metabolic equivalent,Duke score to predict the cut-off point of coronary heart disease The values are 7.1METs and 6.09 respectively.Metabolic equivalent,Duke score,metabolic equivalent combined with Duke score area under the curve(AUC)are:0.753,0.833,0.891 respectively;sensitivity: 78.6%,70.4%,85.1% respectively;specificity: 61.0%,87.3%,73.7%;Youden index: 0.396,0.577,0.588 respectively;the positive predictive value was 71.26%,85.32%,81.65%;the negative predictive value was 69.39%,62.58%,78.07%;the coincidence rate was 70.59%,71.69%,80.15%.Conclusion Metabolic equivalent and Duke score are closely related to the severity of CHD.From the perspective of the diagnostic value of a single index,Duke score is more diagnostic than metabolic equivalent,but the accuracy of a single index is lower;the accuracy of combined detection of metabolic equivalent and Duke score in patients with CHD is higher than that of single index diagnosis,metabolic equivalent combined with Duke score has greater predictive performance in the diagnosis of CHD;the combined detection of the two indicators can be used as a simple and effective indicator for early prediction of CHD,so as to earn time for patients to receive treatment at the best time.By improving the diagnostic value of non-invasive examinations,and avoiding unnecessary invasive examinations and treatments,to a certain extent,it has a good auxiliary and promotion value for areas with scarce medical facilities,such as some villages or grassroots hospitals. |
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