动态心电图、超声及CTA对不同严重程度冠状动脉病变的诊断价值  

Diagnostic Value of Dynamic Electrocardiogram,Ultrasound,and CTA in Coronary Artery Lesions of Different Severity

作　　者：马红丽[1] 任玉菊[2] 许磊 吴荣荣 MA Hong-li;REN Yu-ju;XU Lei;WU Rong-rong(Department of Cardiac Function Examination,Lianyungang Second People’s Hospital,Lianyungang 222000,Jiangsu Province,China;Department of Ultrasound,Lianyungang Second People’s Hospital,Lianyungang 222000,Jiangsu Province,China;Department of Medical Imaging,Lianyungang Second People’s Hospital,Lianyungang 222000,Jiangsu Province,China)

机构地区：[1]连云港市第二人民医院心脏功能检查科,江苏连云港222000 [2]连云港市第二人民医院超声科,江苏连云港222000 [3]连云港市第二人民医院医学影像科,江苏连云港222000

出　　处：《中国CT和MRI杂志》2022年第5期119-122,共4页Chinese Journal of CT and MRI

摘　　要：目的 研究动态心电图(DCG)、颈动脉超声及CT血管造影(CTA)对不同严重程度冠状动脉病变中的诊断价值,方法选取2017年9月至2019年12月我院CHD患者137例为研究对象,均在1个月内完成DCG、颈动脉超声、CTA和冠脉造影(CAG)检查,根据Gensini评分将患者分为轻度组59例、中度组47例和重度组31例,比较各组检查结果并分析DCG、颈动脉超声、CTA对冠脉病变程度诊断价值。结果随着冠脉病变严重程度增加,DCG测量参数正常N-N间期标准差(SDNN)、每5min N-N间期平均值的标准差(SDANN)和相邻N-N间期之差的均方根(RMSSD)均呈明显下降趋势(P<0.05);颈动脉超声测量参数动脉硬化度(β)、弹性系数(EP)及颈动脉中膜厚度(IMT)均呈明显上升趋势(P<0.05),颈动脉顺应性(AC)呈明显下降趋势(P<0.05),且各组间差异有统计学意义(P<0.05);CTA对冠脉狭窄程度评估结果与Gensini评分相比无明显差异(P>0.05);DCG、颈动脉超声和CTA对冠脉病变严重程度进行鉴别的Kappa值分别为0.541、0.752和0.880。结论 DCG、颈动脉超声和CTA用于冠脉病变严重程度诊断均具有良好参考价值,对提升CHD患者诊断和治疗水平具有积极作用。Objective To study the diagnostic value of dynamic electrocardiogram(DCG), carotid artery ultrasound and CT angiography(CTA) in coronary artery lesions of different severity. Methods 137 patients with CHD in the hospital between September 2017 and December 2019 were selected as study subjects.They completed the DCG, carotid artery ultrasound, CTA and coronary angiography(CAG) within 1month. According to the Gensini score, the patients were divided into mild group(59 cases), moderate group(47 cases) and severe group(31 cases). The examination results were compared in each group, and the diagnostic value of DCG, carotid artery ultrasound and CTA on coronary artery lesions was analyzed. Results As the severity of coronary artery lesions increased, the DCG measurement parameters of standard deviation of normal number of intervals(SDNN), standard deviation of per 5 min averages normal number of intervals(SDANN) and root mean square values of the standard deviation between adjacent normal number of intervals(RMSSD) showed significant downward trends(P<0.05). Carotid artery ultrasound measurement parameters of artery hardenability(β), elastic coefficient(EP) and carotid intima-media thickness(IMT) showed an obvious upward trend(P<0.05),carotid compliance(AC)showed an obvious downward trend(P<0.05), and there were statistically significant differences between the groups(P<0.05). The results of CTA assessment of coronary stenosis were not significantly different from those of Gensini score(P>0.05). The Kappa values of DCG, carotid artery ultrasound and CTA in identifying the severity of coronary artery lesions were 0.541,0.752 and 0.880 respectively. Conclusion DCG, carotid artery ultrasound and CTA have good reference value in the diagnosis of severity of coronary artery lesions, and have a positive effect on improving the diagnosis and treatment of CHD patients.

关 键 词：冠状动脉病变 严重程度 诊断 动态心电图 颈动脉超声 CT血管造影 

分 类 号：R445.3[医药卫生—影像医学与核医学] R445.1[医药卫生—诊断学]