256排螺旋CT冠状动脉成像联合血清血小板活化因子及可溶性E-选择素用于冠心病诊断的临床价值分析  

Clinical value of 256-slice spiral CT coronary angiography combined with serum PAF and sE-Selectin for diagnosis of coronary heart disease

作　　者：肖康[1] 王泽静[1] 王询 田珊珊[1] 刘永利[1] XIAO Kang;WANG Ze-jing;WANG Xun;TIAN Shan-shan;LIU Yong-li(CT Room Department of Cardiology,Qihuangdao 066000,China;First Hospital of Qinhuangdao,Qihuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院CT室,河北省秦皇岛市066000 [2]秦皇岛市第一医院心内科,河北省秦皇岛市066000

出　　处：《中国心血管病研究》2020年第7期617-620,638,共5页Chinese Journal of Cardiovascular Research

基　　金：秦皇岛市科学技术研究与发展计划(201401A090)。

摘　　要：目的探讨256排螺旋CT冠状动脉成像联合血清血小板活化因子(platelet activating factor,PAF)和可溶性E-选择素(sE-Selectin)用于冠心病诊断的临床价值.方法选取2017年7月至2019年1月我院收治的125例冠心病患者为观察组研究对象,及同期健康受试者48例为对照组研究对象,两组患者均行256排螺旋CT冠状动脉成像检查,空腹抽取静脉血监测血清PAF、sE-Selectin水平,比较两组患者256排螺旋CT冠状动脉成像结果、血清PAF、sE-Selectin水平,通过受试者工作特征(receiver operating characteristic,ROC)曲线评估单一指标及联合检测诊断效能.结果观察组患者256排螺旋CT冠状动脉成像阳性率为88.00%,明显多于对照组的6.25%(P<0.05),观察组患者血清PAF[(18.24±3.71)ng/ml比(8.94±1.65)ng/ml]和sE-Selectin[(43.21±6.43)ng/ml比(28.62±4.48)ng/ml]水平均明显高于对照组(P<0.05).256排螺旋CT冠状动脉成像诊断的敏感度为69.6%,特异度为75.0%;ROC曲线下面积为0.731(95%CI 0.674~0.789).血清PAF诊断的临界值11.31 ng/ml,敏感度为63.2%,特异度为77.0%;ROC曲线下面积为0.651(95%CI 0.601~0.700).血清sE-Selectin诊断的临界值为34.17 ng/ml,敏感度为62.4%,特异度为79.2%;ROC曲线下面积为0.665(95%CI 0.614~0.716).三者联合诊断冠心病敏感度为83.2%,特异度为77.0%;ROC曲线下面积为0.802(95%CI 0.757~0.847),优于单一指标诊断.结论256排螺旋CT冠状动脉成像联合血清PAF和sE-Selectin可有效提高冠心病诊断诊断效能,对冠心病早期诊断具有重要价值.Objective To investigate clinical value of 256-slice spiral CT coronary angiography combined with serum platelet activating factor(PAF)and sE-Selectin for diagnosis of coronary heart disease.Methods 125 patients with coronary heart disease in our hospital from July 2017 to January 2019 were enrolled as the observation group and 48 healthy subjects in our hospital were enrolled as the control group.256-slice spiral CT coronary angiography was performed in both group,venous blood was collected to monitor serum PAF and sE-Selectin levels.Comparing of 256-slice spiral CT coronary angiography results,serum PAF and sE-Selectin levels,the single index and combined detection and the diagnostic efficacy were evaluated.Results The positive rate of coronary artery imaging with 256-slice spiral CT in the observation group was 88.00%,which was significantly higher than that in the control group(6.25%)(P<0.05).The serumlevels of PAF:[(18.24±3.71)ng/ml vs.(8.94±1.65)ng/ml]and sE-Selectin [(43.21±6.43)ng/ml vs.(28.62±4.48)ng/ml]in the observation group were significantly higher than those in the control group(P<0.05).The sensitivity o f 256-slice spiral CT coronary angiography was 69.6% and specificity was 75.0%;the area under the ROC curve was 0.731(95% CI 0.674-0.789).The critical value of serum PAF diagnosis was 11.31 ng/ml;the corresponding sensitivity was 63.2% and the specificity was 77.0%,area under the ROC curve was 0.651(95%CI 0.601-0.700).The critical value of serum sE-Selectin diagnosis was 34.17 ng/ml;sensitivity was 62.4%,the specificity was 79.2% and the area under the ROC curve was 0.665(95%CI 0.614-0.716).The sensitivity of the combined diagnosis of coronary heart disease was 83.2%;the specificity was 77.0% and the area under the ROC curve was 0.802(95%CI 0.757-0.847),which was better than the single index diagnosis.Conclusion 256-slice spiral CT coronary angiography combined with serum PAF and sE-Selectin can effectively improve the performance of coronary heart disease diagnosis and is of great value for ea

关 键 词：256排螺旋CT冠状动脉成像 血小板活化因子 可溶性E-选择素 冠状动脉疾病 

分 类 号：R541.4[医药卫生—心血管疾病]