超声心动图和核素心肌灌注显像对冠状动脉粥样硬化性心脏病诊断及心功能评估价值  

The value of echocardiography and nuclide myocardial perfusion imaging in the diagnosis and evaluation of cardiac function of coronary atherosclerotic heart disease

作　　者：薛军[1] 崔伟[2] 杨霜[2] 常垚垚 樊学超 XUE Jun;CUI Wei;YANG Shuang;CHANG Yao-yao;FAN Xue-chao(Department of Nuclearmedcine,Shengli Oilfield Central Hospital,Dongying 257000,Shandong,China;Department of Ultrasonography,Shengli Oilfield Central Hospital,Dongying 257000,Shandong,China)

机构地区：[1]胜利油田中心医院核医学科,山东东营257000 [2]胜利油田中心医院超声检查科,山东东营257000

出　　处：《川北医学院学报》2020年第4期710-712,720,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨超声心动图(UCG)和核素心肌灌注显像(SPECT)对冠状动脉粥样硬化心脏病(CHD)诊断及心功能的评估价值。方法:118例疑似CHD患者,入院后均接受UCG和SPECT检查,以冠状动脉造影(CAG)检查结果为金标准,比较UCG和SPECT对CHD的诊断价值,计算敏感度、特异度和准确度。比较UCG和SPECT检查方法测量左心室舒张末容积(LVEDV)、左心室收缩末容积(LVESV)和左心室射血分数(LVEF),采用Pearson法分析二者LVEDV、LVESV、LVEF的相关性。结果:CAG检查确诊107例(90.68%)CHD患者,余下11例分别为心包炎5例,心肌炎4例和胸膜炎2例。参照CAG金标准,SPECT检查诊断CHD灵敏度为86.92%(93/107),高于UCG检查的75.70%(81/107),差异有统计学意义(χ^2=4.428,P<0.05);SPECT特异度、准确度分别为72.73%(8/11)、86.44%(101/118),与UCG检查的81.82(9/11)、76.27(90/118)比较,差异均无统计学意义(P>0.05)。107例CHD患者UCG与SPECT心功能检测指标比较,二者LVEDV、LVESV、LVEF均较接近,差异均无统计学意义(P>0.05);Pearson法分析显示,二者检测LVEDV、LVESV、LVEF均呈正相关(r=0.781、0.812、0.805,P<0.05)。结论:UCG和SPECT诊断CHD和心功能评估价值均较好,UCG诊断CHD灵敏度不及SPECT,特异性和准确度相当,但SPECT检查有辐射,且检查操作相对繁琐,二者各有优点和不足。Objective:To investigate the value of ultrasonic cardiography(UCG)and single photon emission computed myocardial imaging(SPECT)in the diagnosis of coronary heart disease(CHD).Methods:118 suspected CHD patients were examined by UCG and SPECT.The results of coronary angiography(CAG)were used as the gold standard to compare the diagnostic value of UCG and SPECT for CHD and calculate the sensitivity,specificity and accuracy.Left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)and left ventricular ejection fraction(LVEF)were measured by UCG and SPECT,and the correlation between LVEDV,LVESV and LVEF were analyzed by Pearson method.Results:90.68%(107/118)CHD was confirmed by CAG,the remaining 11 cases were pericarditis(5 cases),myocarditis(4 cases)and pleurisy(2 cases).According to CAG gold standard,the sensitivity of SPECT in the diagnosis of CHD was 86.92%(93/107),which was higher than 75.70%of UCG(81/107),the difference was statistically significant(χ^2=4.428,P<0.05).The specificity and accuracy of SPECT were 72.73%(8/11)and 86.44%(101/118),respectively.Compared with UCG(81.82(9/11)and 76.27(90/118),the difference was not statistically significant(P>0.05).Comparison between UCG and SPECT in 107 CHD patients,the LVEDV,LVESV and LVEF of the two were close,and the difference was not statistically significant(P>0.05).Pearson analysis showed that there was a positive correlation between LVEDV,LVESV and LVEF(r=0.781,0.812,0.805,P<0.05).Conclusion:The value of UCG and SPECT in the diagnosis of CHD and the evaluation of cardiac function is better.The sensitivity of UCG in the diagnosis of CHD is lower than that of SPECT,and the specificity and accuracy are the same.However,SPECT examination has radiation,and the operation is relatively complicated.Both have advantages and disadvantages.

关 键 词：冠状动脉粥样硬化心脏病 超声心动图 核素心肌灌注显像 诊断 心功能 相关性 

分 类 号：R543.3[医药卫生—心血管疾病]