应用ROC曲线评价颈总动脉内中膜厚度对冠心病的诊断价值  

Evaluating the value of carotid artery intima media thickness in diagnosis of coronary artery disease by ROC curve

作　　者：李自成[1] 刘勇[2] 巫少荣[1] 徐宏贵[1] 张爱东[1] 王巍嵩[1] 黄贤珍[1] 

机构地区：[1]暨南大学附属第一医院心内科,广州510630 [2]东莞市桥头医院内科

出　　处：《临床心血管病杂志》2004年第6期337-339,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨冠心病 (CHD)患者颈动脉内中膜厚度 (IMT)及粥样斑块的发生情况 ,及其对CHD的诊断价值。方法 :据冠状动脉造影将 76例患者分为CHD组 (5 2例 )和非CHD组 (2 4例 ) ,分别进行颈动脉超声检查 ,应用受试者工作特征 (ROC)曲线评价颈总动脉IMT ,以冠状动脉造影作为金标准 ,计算IMT及粥样斑块诊断CHD的灵敏性、特异性。结果 :非CHD组及CHD组IMT分别为 (0 .79± 0 .11)及 (1.11± 0 .37)mm ,斑块发生率分别为 8.3% (2 / 2 4 )及 71.2 % (37/ 5 2 ) ,两组间比较均差异有统计学意义 (P <0 .0 1)。颈总动脉IMT诊断CHD的ROC曲线下面积 (AUC)为 0 .80 ,IMT诊断CHD的最佳分界值为 0 .90mm ,以IMT≥ 0 .90mm及 (或 )出现粥样斑块来预测CHD ,敏感性 82 .7% ,特异性 79.2 %。结论 :颈总动脉IMT对诊断CHD有一定的准确性 ,IMT≥ 0 .90mm及 (或 )出现粥样斑块是预测CHD较为敏感的指标。Objective:Using receiver operating characteristic(ROC) curve to evaluate the value of carotid artery intima media thickness(IMT) and atheromatous plaque detected by B-mode ultrasound in diagnosis of coronary heart disease (CHD).Method:According to the result of coronary angiography, 76 cases were divided into the group CHD (n=52) and the group without CHD(n=24), they received carotid artery B-mode ultrasound test. the value of IMT and atheromatous plaque in detection of CHD was evaluated by using ROC curve. The sensitivity and specificity were calculated with gold standard of CHD.Result:The IMT in non-CHD group and CHD group were ( 0.79± 0.11)mm and ( 1.11± 0.37)mm, the prevalence rate of atheromatous plaque were 8.3%(2/24) and 71.2%(37/52) respectively. There were significant differences between the two groups(P< 0.01). The area under cure (AUC) of ROC was 0.80, at peak point of the ROC curve the IMT was 0.9 mm. IMT≥ 0.90 mm of the common carotid artery (CCA) and(or) the occurrence of atheromatous plaque could predict the presence of CHD with a sensitivity of 82.7% and spectificity of 79.2%.Conclusion:The IMT of CCA is accurate in detection of CHD, IMT≥ 0.90 mm and (or) atheromatous plaque is a valuable predictor of CHD.

关 键 词：冠状动脉疾病 动脉粥样硬化 颈动脉内中膜厚度 超声检查 

分 类 号：R543.3[医药卫生—心血管疾病] R543.5[医药卫生—内科学]