颈动脉内中膜与左室舒张功能联合检测对冠心病的预测价值  

The predictive effect of US detection of carotid artery combined with left ventricular diastolic function measuring on coronary heart disease

作　　者：葛海燕[1,2] 张炽敏[1] 李卫民[1] 高亚琴[1] 张晓峰[3] 

机构地区：[1]东南大学医学院附属中大医院超声科,江苏南京210009 [2]江苏省钟山干部疗养院超声科,江苏南京210014 [3]东南大学附属南京市第二医院心内科,江苏南京210003

出　　处：《现代医学》2015年第8期990-994,共5页Modern Medical Journal

摘　　要：目的:探讨颈动脉内中膜病变检测结合左室舒张功能(LVDF)测定对冠心病的预测作用。方法:临床拟诊冠心病行冠状动脉造影检查的患者进行术前颈动脉超声检查和心脏LVDF测定,根据超声检查结果分为颈动脉正常组、颈动脉异常组,LVDF正常组、LVDF减低组,分别与冠状动脉造影结果做比较,对单一指标和复合指标的预测结果进行比较。结果:200例患者中男105例,女95例,年龄(64.66±9.382)岁,超声检测到颈动脉内中膜病变102例,LVDF减低127例,冠状动脉造影阳性112例,阴性88例。颈动脉粥样硬化Crouse积分和斑块数比较,冠心病组与非冠心病组差异有统计学意义。以LVDF指标比较,冠心病组与非冠心病组间差异也有统计学意义。颈动脉超声检查加LVDF测定的结果与冠脉造影结果比较,灵敏度为88.39%,特异度为46.59%,阳性预测值为67.81%,阴性预测值为75.93%。结论:颈动脉超声检查联合LVDF超声检查可以提高对冠心病的风险预测价值,作为一种在冠状动脉造影前的无创性预筛检查,具有临床实用意义。Objective： To evaluate the accuracy of combined detection of carotid artery intima-media lesions by ultrasound and left ventricular diastolic function（ LVDF） on the diagnosis of coronary artery disease（ CAD）.Methods： 200 suspected CAD patients were chosen and undergoing the examination of both carotid ultrasound and echocardiography before coronary angiography. Comparative analysis were then conducted between the ultrasound and subsequent coronary angiography results in each group. Results： CAD patients showed statistically difference with non-CAD patients（ P〈0. 05） on the carotid lesions crouse and number of plaques. We further identified siginificant difference of the LVDF（ including peak E,E / A ratio,DT,IVRT,LAD） between CAD and non-CAD patients（ P〈0. 05）. Combined detection using carotid ultrasound and echocardiography showed a high predictive value on the diagnosis of CAD with a sensitivity of 88. 39%,speciality of 46. 59%,positive predictive value of67. 81% and negative predictive value of 75. 93%. Conclusion： Combined detection using carotid ultrasound and echocardiography for suspected CAD patients could improve the risk forecast in CAD. As a noninvasive preliminary screening method before coronary angiography,our findings show significant clinical values.

关 键 词：颈动脉内中膜 左室舒张功能 冠心病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]