心脏无创检查在冠心病诊断中的对比分析及应用研究  

Comparative analysis and application of cardiac noninvasive examination in the diagnosis of coronary heart disease

作　　者：宋炳慧[1] 王书清[1] 姜波[1] 魏冬梅[1] 谢广宇[1] 陈宏[1] 

机构地区：[1]齐齐哈尔市第一医院心内科,黑龙江齐齐哈尔161005

出　　处：《心血管康复医学杂志》2017年第2期193-196,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:评价3种无创性检查对冠心病(CHD)的诊断价值。方法:选择2014年5月至2015年5月在我院心内科住院、疑诊CHD并初次行诊断性冠脉造影(CAG)者500例。根据CAG结果,入选者被分为非CHD对照组(106例)、单支病变组(199例)、双支病变组(95例)和多支病变组(100例,≥3支病变)。除CAG外,所有研究对象完成下列至少1项检查:(1)24h动态心电图(Holter);(2)实时三维超声心动图(RT-3DE);(3)核素心肌灌注显像(RMPI)。评价这3种无创性检查诊断CHD的敏感性、特异性、准确性。结果:以CAG作为金标准,与Holter、RT-3DE比较,RMPI的敏感性(68.4%,69.0%比92.9%)、特异性(62.9%、81.4%比88.5%)和准确性(67.1%、71.2%比91.9%)均显著升高(P均<0.01),RT-3DE仅特异性显著高于Holter(P=0.019)。结论:无创性检查可作为诊断冠心病的重要方法,是无创性诊断、评价冠心病的重要手段,且核素心肌灌注显像诊断的准确性、敏感性和特异性较高,值得推广。Objective： To evaluate diagnostic value of three noninvasive examinations for coronary heart disease （CHD）. Methods： A total of 500 subjects, who were suspected of CHD, first received diagnostic coronary angiography （CAG） and hospitalized in our department from May 2014 to May 2015, were selected. According to CAG results, they were divided into non-CHD control group （n = 106）, single vessel coronary disease group （n = 199）, double-vessel coronary disease group （n = 95） and multi-vessel coronary disease group （n = 100, ≥three vessel disease） . Besides CAG, all subjects accomplished one of following examinations at least： （1） 24h dynamic ECG （Holter）; （2） real-time three-dimensional echocardiography （RT-3DE）; （3） radionuclide myocardial perfusion imaging （RM- PI） . Sensitivity, specificity and accuracy of these three examinations in diagnosing CHD were evaluated. Results： With CAG as the gold standard, compared with Holter and RT-3DE, there were significant rise in sensitivity （68. 4%, 69. 0% vs. 92.9%）, specificity （62. 9%, 81.4% vs. 88. 5%） and accuracy （67. 1%, 71.2% vs. 91.9%） of RMPI （P〈0. 01 all）, only specificity of RT-3DE was significantly higher than that of Holter, P = 0. 019. Conclusion： Noninvasive examination can be used as important method diagnosing CHD, which are important measures for noninvasive diagnosing and assessing CHD. Accuracy, sensitivity and specificity of RMPI are high, which is worth extending.

关 键 词：心电描记术 便携式 超声心动描记术 三维 冠心病 

分 类 号：R541.4[医药卫生—心血管疾病]