64排螺旋CT冠脉成像诊断冠心病合并糖尿病的准确性影响因素分析  

Analysis of Influencing Factors for the Accuracy of 64 Row Spiral CT Coronary Artery Imaging in the Diagnosis of Coronary Heart Disease with Diabetes Mellitus

作　　者：殷晶晶[1] 肖甜甜[1] 王昕怡[1] 李明泉[1] 舒磊[1] 陈祥菲[1] 王鹏[2] 赵明[1] 

机构地区：[1]南京军区南京总医院内分泌科,江苏南京210000 [2]南京军区南京总医院影像科,江苏南京210000

出　　处：《中国CT和MRI杂志》2016年第11期43-46,共4页Chinese Journal of CT and MRI

基　　金：南京军区南京总医院科研课题2015066

摘　　要：目的分析64排螺旋CT冠脉成像诊断冠心病合并糖尿病的准确性影响因素。方法分析我院248例冠心病合并糖尿病患者的临床资料。将患者按照钙化积分、平均心率、心率波动及空腹血糖浓度的不同程度进行分组,以CAG诊断结果为金标准,计算各组64排螺旋CT冠脉成像评估冠脉狭窄≥50%敏感度、特异度、阳性预测值、阴性预测值及诊断符合率并进行统计学分析。结果 (1)64排螺旋CT冠脉成像及CAG共同显影及评估的冠脉节段有2036节段,其中男性1424节段,女性612节段;(2)以CAG为金标准,64排螺旋CT冠脉成像诊断轻度钙化组特异度、阳性预测值及诊断符合率均高于重度钙化组,经统计学分析,差异具有统计学意义(P<0.05);诊断心率分组(心率>70次/min及心率≤70次/min组)、心率波动分组(心率波动>15次/min及心率波动≤15次/min组)及空腹血糖分组(空腹血糖>10.00mmol/L及空腹血糖≤10.00mmol/L组)的敏感度、特异度、阳性预测值、阴性预测值及诊断符合率均无明显差异(P>0.05);诊断男性、女性组的特异度、阴性预测值及诊断符合率均无明显差异,诊断女性组灵敏度及阳性预测值低于男性组,差异具有统计学意义(P<0.05)。结论严重的冠脉钙化降低64排螺旋CT冠脉成像的诊断准确性,在高心率及心率波动下64排螺旋CT冠脉成像仍具有较高的诊断准确性,诊断女性患者敏感度及阳性预测值低于男性,空腹血糖高低对其诊断准确性无明显影响。Objective To analyze the factors affecting the accuracy of 64 row spiral CT coronary artery imaging in the diagnosis of coronary heart disease with diabetes. Methods To retrospectively analyze 248 cases of patients coronary heart disease with diabetes mellitus who underwent 64 row spiral CT coronary artery imaging and coronary angiography（CAG） examination in our hospital. They were divided into groups according to calcification score, the average heart rate, heart rate, fluctuation and fasting plasma glucose concentrations. different level to the CAG diagnosis as the gold standard, each 64 row spiral CT coronary artery imaging evaluation of coronary artery stenosis degree of 50% or higher sensitivity, specific, positive predictive value, negative predictive value and the diagnostic coincidence rate and statistical analysis. Results（1）64 row spiral CT coronary artery imaging and CAG common development, and evaluation of 2036 segmental coronary segments, 1424 segments of men, 612 segment of women,（2） CAG as the gold standard, 64 row spiral CT coronary artery imaging in the diagnosis of mild degree of calcification group specific, positive predictive value and the diagnosis coincidence rate were higher than in severe calcification group, after statistics analysis, the difference statistically significant（P〈0.05）. Grouping diagnosis of heart rate（heart rate70 times/min and heart rate of 〉70 times/min or less） and heart rate fluctuations group（heart rate fluctuations15 times/min and heart rate group 〉15 times/min or less） and fasting plasma glucose group（fasting glucose〉10.00mmol/L and fasting plasma glucose group≤10.00mmol/L） or less sensitivity, specific, positive predictive value, negative predictive value and diagnostic coincidence rate had no obvious difference（P〉0.05）. Diagnosis of male and female specific degree, negative predictive value and the diagnosis coincidence rate had no obvious difference, diagnosis of female sensitivity and positive predictive value is lowe

关 键 词：冠心病 糖尿病 准确性 

分 类 号：R445.3[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]