双源CT与12导联动态心电图对冠心病的诊断及近期预后的预测价值  

Dual-source CT and 12-lead Ambulatory Electrocardiogram in the Diagnosis of Coronary Heart Disease and Its Predictive Value on Short-term Prognosis

作　　者：席延琴 孙华[1] 肖湘豫 Xi Yan-qin;Sun Hua;Xiao Xiang-yu(Department of Cardiac Function,Zhengzhou People's Hospital,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州人民医院心功能科,河南郑州450000

出　　处：《中国CT和MRI杂志》2021年第9期71-74,共4页Chinese Journal of CT and MRI

摘　　要：目的评价双源CT冠脉成像与12导联动态心电图(AECG)对冠心病的诊断价值及对患者近期不良心脏事件(MACE)的预测价值。方法研究选取2018年1月至2018年12月88例可疑冠心病患者,患者均行12导联AECG、双源CT冠脉成像、冠脉造影检查,以冠脉造影结果为标准,评价12导联AECG、双源CT的诊断效能;对确诊冠心病患者进行6个月随访,观察MACE发生情况,并分析影响MACE发生的危险因素,评价12导联AECG下心肌缺血指标及双源CT冠脉成像下钙化积分及斑块性质对MACE的预测价值。结果88例患者经冠脉造影诊断冠心病61例,12导联AECG诊断的灵敏度、特异度、准确度分别为78.69%、62.96%、73.86%,双源CT冠脉成像诊断的灵敏度、特异度、准确度分别为93.44%、92.59%、93.18%;MACE组年龄、冠脉病变支数、12导联AECG结果中心肌缺血发作次数以及双源CT冠脉成像结果中冠脉钙化总积分、伴钙化斑块冠脉支数、伴软斑块冠脉支数均显著高于无MACE组(P<0.05);Cox回归分析显示,心肌缺血发作次数、冠脉钙化总积分、伴软斑块冠脉支数是冠心病患者近期不良心脏事件发生的独立预测因子(P<0.05)。结论双源CT冠脉成像与12导联AECG对冠心病均有一定诊断价值,而前者诊断效能更高,且12导联AECG下心肌缺血指标及双源CT冠脉成像下钙化积分及斑块性质对MACE发生有预测价值。Objective To evaluate the diagnostic value of dual-source CT coronary angiography and 12-lead ambulatory electrocardiogram(AECG) on coronary heart disease and its predictive value on shortterm adverse cardiac events(MACE).Methods A total of 88 patients with suspected coronary heart disease from January 2018 to December 2018 were selected.All patients underwent 12-lead AECG,dual-source CT coronary imaging and coronary angiography.Results of coron a ry angiography were taken as the standards to evaluate the diagnostic efficacy of 12-lead AECG and dual-source CT.Patients confirmed as coronary heart disease were given 6 months of follow-up,and the occurrence of MACE was observed,and the risk factors affecting occurrence of MACE was analyzed,and the predictive value of myoca rdial ischemia indexes under 12-lead AECG and calcification score and plaque properties under dual-source CT coronary imaging on MACE was evaluated.Results 61 cases among88 patients were diagnosed with coronary heart disease by corona ry angiography,and the sensitivity,specificity and accuracy of 12-lead AECG diagnosis were 78.69%,62.96% and 73.86% respectively,and the sensitivity,specificity and accuracy of dual-source CT coronary imaging diagnosis were 93.44%,92.59% and 93.18% respectively.The age,count of coronary lesions,frequency of myoca rdial ischemic attacks in 12-lead AECG and the total score of coronary artery calcification,count of coronary artery with calcified plaque and count of coronary artery with soft plaque in dual-source CT coronary imaging were significantly higher in MACE group than those in non-MACE group(P<0.05).Cox regression analysis showed that the frequency of myocardial ischemic attacks,total score of coronary artery calcification and count of coronary artery with soft plaque were independent predictors of shortterm adverse ca rdiac events in patients with coronary heart disease(P<0.05).Conclusion Dual-sou rce CT coronary angiography and 12-lead AECG have certain diagnostic value on coronary heart disease,but the former

关 键 词：冠心病 双源CT 十二导联动态心电图 不良心脏事件 

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]