心绞痛患者应用CT冠脉血管成像技术进行诊断的临床意义  

CLINICAL DIAGNOSIS VALUE OF CT CORONARY ARTERY ANGIOGRAPHY IN THE ANGINA PECTORIS PATIENTS

作　　者：高战强[1] 齐杰[1] 

机构地区：[1]河北省廊坊市第四人民医院CT室,065000

出　　处：《中国煤炭工业医学杂志》2016年第5期672-675,共4页Chinese Journal of Coal Industry Medicine

基　　金：河北省科学技术研究与发展计划项目(10276146)

摘　　要：目的对CT冠脉血管成像（CTA）技术诊断心绞痛患者的临床价值进行评估。方法选择该院心血管内科收治的69例心绞痛患者作为研究对象,分别采用CTA和冠状动脉造影（CAG）对患者进行检查,以CAG作为参照,对CTA诊断心绞痛的应用价值进行评价。结果 CAG检查共诊断182支冠脉血管无狭窄,诊断〈50%狭窄程度31支血管、50%~75%血管管腔狭窄程度53支、〉75%程度狭窄血管10支;CTA检查诊断179支冠脉血管无狭窄,诊断〈50%狭窄程度38支血管、50%~75%血管管腔狭窄程度49支、〉75%程度狭窄血管10支;CTA和CAG诊断阳性结果一致的有85支血管,诊断阴性结果一致的有170支血管,二种检查方法检测结果的一致性分析Kappa=0.832,P=0.000〈0.001,CTA诊断冠脉狭窄的灵敏度：90.43%、特异度：93.41%、漏诊率：9.57%、误诊率：6.59%。CTA与CAG诊断LM、LAD、LCX、RCA狭窄的结果进行比较分析差异均无统计学意义（P〉0.05）。结论对于心绞痛患者应用CTA检查诊断冠脉病变的结果与CAG具有极高的一致性,但是CTA具有无创、操作简单的优势,可以作为临床上对疑似心绞痛患者的一种筛查手段应用。Objective To investigate the clinical value of CT coronary artery angiography （CTA） on diagnosis of patients with angina pectoris. Methods Totally 69 patients with angina pectoris, using CTA and coronary angiography （CAG） examine respectively, were collected as the research subjects. The application value of CTA diagnosis on angina pectoris were evaluated. Results Sensitivity of stenosis diagnosis, 182coronary blood vessels of 69 patients were not diagnosed as coronary vascular stenosis by coronary angiography （CAG）, among other coronary blood vessels, 31 vessels were diagnosed as less than 50% steno sis, 53 in 500% to 75% of vascular lumen stenosis, 10 in 75% stenosis. While 179 coronary blood vessels were not diagnosed as coronary vascular stenosis by coronary angiography （CAG） ,CTA diagnosis 179 coro- nary vascular stenosis, 38 vessels were diagnosed as less than 50% stenosis, 48 in 50% to 75% of the vas cular lumen stenosis,10 in 75% stenosis. The positive and negative results of CTA and CAG diagnosis for coronary vascular stenosis were consistent with 85 vessels and 170 vessels respectively, consistency analysis of two methods： kappa= 0. 832, P%0. 001. By CTA diagnosis, sensitivity of 90.43%, specificity of 93. 41%, missed diagnosis rate of 9.57%, and misdiagnosis rate of 6.59%. The diagnosis of CTA and CAG on LM, LAD, LCX and RCA was not statistically significant difference （P〉0.05）. Conclusions For angi na pectoris patients with CTA in the diagnosis of coronary artery disease is high consistency with CAG, but CTA is a noninvasive and simple operation, and it can be used as a screening method for suspected angina pectoris patients in clinic.

关 键 词：X线计算机体层冠脉血管成像 冠状动脉造影 心绞痛 

分 类 号：R445.3[医药卫生—影像医学与核医学]