冠心病危险因素对症状不典型冠心病诊断的价值  

Value of independent risk factors in clinical diagnosis of suspected coronary disease without typical symptom

作　　者：李永生[1] 王新萍[1] 黄浙勇[2] 江时森[3] 

机构地区：[1]南京军区杭州疗养院心内科,杭州310007 [2]复旦大学中山医院上海市心血管病研究所 [3]南京军区总医院心内科

出　　处：《中华老年心脑血管病杂志》2007年第10期668-670,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨冠心病危险因素在症状不典型的可疑冠心病临床诊断中的价值。方法以选择性冠状动脉造影为金标准，对430例临床诊断可疑冠心病患者的主要冠心病危险因素（年龄、性别、糖尿病、血脂异常及高血压）和临床诊断符合率的关系进行分析。结果430例患者症状不典型的可疑冠心病的临床诊断符合率为51．9％。无危险因素时冠心病临床诊断符合率仅为13．3％，伴1～5个危险因素时诊断符合率分别为29．1％、55．3％、62．7％、69．2％和100．0％。患者年龄越大，符合率越高，误诊越少。男性、有糖尿病史、血脂异常患者符合率显著增高（P〈0．01）。高血压史对诊断符合率无明显影响（P〉0．05）。结论冠心病整体危险因素评估对症状不典型可疑冠心病的临床诊断有重要参考价值。Objective To investigate the role of independent risk factors in clinical diagnosis of coronary artery disease（CAD） without typical symptom. Methods A total of 430 consecutive patients without typical symptom and suspected of CAD were studied. All patients underwent selective coronary angiography and received a survey of risk factors, including age, gender, diabetes, hyperlipemia and hypertension. Then the relations between different risk factors and clinical diagnostic accuracy were identified. Results Compared with the coronary angiographic findings, the clinical diagnostic accuracy in suspected CAD patients with 0, 1, 2, 3, 4 and 5 risk factors was 29.1%, 55.3 %, 62. 7 %, 69.2 % and 100. 0% respectively, while the general diagnostic accuracy was 51.9%. The clinical diagnosis was more accurate in aged patients, male, patients with diabetes or hyperlipemia than their respective counterpart. Hypertension had no significant influence on the diagnostic accuracy（ P〉0. 05）. Conclusion The CAD risk factors are of great significance in the clinical diagnosis of susoected CAD without tvnical symptom.

关 键 词：冠状动脉疾病 诊断 冠状血管造影术 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]