冠状动脉影像学与心电图检查诊断老年冠心病价值的对比研究  

Comparison of computed tomographic coronary angiography and ECG in diagnosis of coronary artery disease in elders

作　　者：魏文娟[1] 钱正明[1] 黄建振[1] 黄德运[1] 高佳儿[1] 章保勇 邱原刚 

机构地区：[1]杭州市萧山区第一人民医院心内科,311200 [2]浙江省中医药大学附属第一医院心内科

出　　处：《心电与循环》2014年第6期487-489,共3页Journal of Electrocardiology and Circulation

摘　　要：目的比较冠状动脉CT血管造影(CTA)与心电图对老年冠心病(CHD)患者的诊断价值.方法选择拟诊冠心病的老年住院患者148例,分别行冠状动脉CTA和心电图检查。其中有96例同时行冠状动脉造影检查。按冠状动脉造影结果分析冠状动脉CTA及心电图诊断冠心病的敏感度(阳性率)、特异度(阴性率)结果冠状动脉CTA的敏感度为901%、特异度为881%、符合率为88 8%心电图诊断CHD的敏感度为720%、特异度为571%、符合率为68 8%。冠状动脉造影狭窄程度≥90%的病变,心电图的敏感度最高,假阴性率最低;狭窄程度<90%者与≥90%者比较,心电图敏感度较低,差异显著(均P<001)结论冠状动脉CTA发现有意义血管狭窄的敏感度、特异度较高,可作为老年冠心病诊断的有效方法;Objective To compare the value of computed tomographic coronary angiograpy （CTA） and electrocardiogram （ECG） in diagnosis of coronary artery disease （CAD） in elders. Methods 148 elders admitted for suspicious CAD were included and underwent CTA and ECG examination. Of them, 96 cases underwent coronary angiography. The sensitivity and specificity of CTA and ECG in diagnosis of CAD were determined based on the results of coronary angiography. Results The sensitivity, specificity and accuracy of CTA were 90.1%, 88.1% and 88.8%, respectively, those of ECG were 72%, 57.1%and 68.8%, respectively, in the diagnosis of CAD. The sensitivity of ECG was highest and false negative rate lowest in cases with vessel stenosis ≥90%. It was significantly lower in cases with stenosis 〈90% than in cases with stenosis≥ 90%（P〈0.01）. Conclusion Coronary CTA had higher sensitivity and specificity in detection of critical coronary stenosis and maybe used as an effective method in diagnosis of CAD in elders. ECG is of some value in diagnosis of serious coronary stenosis in elders.

关 键 词：冠状动脉造影 冠状动脉CTA 心电图 

分 类 号：R541.4[医药卫生—心血管疾病] R540.41[医药卫生—内科学] R816.2[医药卫生—临床医学]