多项临床指标评价冠心病的价值  

Value of five methods for diagnosis of coronary heart disease

作　　者：王瑛[1] 赵福玉[1] 侯凤霞[1] 刘少岩[1] 邱若旗[1] 杨国慧[1] 王照谦[2] 齐景伟[1] 孙阳[1] 苏伟[1] 

机构地区：[1]长春市中心医院,吉林长春130051 [2]大连医科大学附属第一医院

出　　处：《心血管康复医学杂志》2005年第5期429-431,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：吉林省科委基金资助项目(合同号:20030419-02)。

摘　　要：目的:比较临床多项无创检查指标在冠心病诊断中的价值。方法:48例诊断或疑有冠心病的患者同时行选择性冠脉造影(CAG)、多层螺旋CT(MSCT)冠脉成像、心电图、超敏C反应蛋白(hsCRP)、肌钙蛋白I(cTnI)、超声心动图等检查。以CAG检查为金标准,比较其他检查对冠心病诊断的准确性。结果:MSCT冠脉成像、心电图、hsCRP、cTnI、超声心动图检查显示,其诊断≥中度冠脉狭窄(狭窄≥50%)的冠心病的敏感度分别为88.24%、76.47%、70.59%、58.82%、41.18%,特异度为92.86%、89.65%、57.14%、78.57%、85.71%,,阳性预测值99.77%、78.79%、77.47%、86.96%、87.5%,阴性预测值76.47%、46.67%、44%、44%、37.5%,准确度为89.58%、78%、65.31%、64.58%、54.17%。结论:本研究各无创检查指标均有助于冠心病的诊断,其中MSCT冠状动脉成像诊断价值很高。Objective： To evaluate the value of five non-traumatic examination for diagnosis of coronary heart disease （CHD）. Methods： Selective coronary angiography （CAG）, multilayer-spiral CT （MSCT） coronary artery imaging, electrocardiogram （ECG）, hypersensitive Creactive protein （hsCRP）, troponin I （cTnI） and ultrasonic cardiogram （UCG） were all applied to diagnosing CHD in 48 patients with CHD or dubious CHD. The selective CAG was selected as gold standard for diagnosising CHD. Results： The diagnosis sensitivity of MCST coronary artery imaging, ECG, hsCRP, cTnI, UCG in order was 88. 24%, 76.47%, 70. 59%, 58.82% and 41.18% ; the specificity also in order was 92.86%, 89.65%, 57.14%, 78.57% and 85.71%; the positive predicted value in order was 99.77%, 78. 97%, 77.47%, 86.96% and 87.5%; the negative predicted value respectively was 76.47%, 46.67%, 44%, 44% and 37.5% ; the accuracy respectively was 89.85%, 78%, 65.31%, 64.58% and 54.17% for diagnosing CHD compared with CAG. Conclusion： All five methods are valuable to diagnosing coronary heart disease, and the MSCT coronary artery imaging possesses more diagnostic value compared to the others.

关 键 词：体层摄影术 螺旋计算机 心电图 C反应蛋白质 CTNI 超声心动图 冠心病诊断 诊断价值 指标评价 临床 选择性冠脉造影 

分 类 号：R446[医药卫生—诊断学] R735.7[医药卫生—临床医学]