双源CT冠脉成像与12导联动态心电图在冠心病诊断及不良心脏事件预测中的应用价值研究  

A Study of the Value of Dual-source CT Coronary Imaging and 12-Lead Ambulatory Electrocardiography in the Diagnosis of Coronary Artery Disease and Prediction of Adverse Cardiac Events

作　　者：杨敏 张雷 李丽丽 YANG Min;ZHANG Lei;LI Li-li(Department of Cardiology and Physiology,Xi'an People's Hospital,Xi'an 710000,Shaanxi Province,China;Imaging Center,Xi'an People's Hospital,Xi'an 710000,Shaanxi Province,China)

机构地区：[1]西安市人民医院心电生理科,陕西西安710000 [2]西安市人民医院影像中心,陕西西安710000

出　　处：《中国CT和MRI杂志》2024年第12期70-73,共4页Chinese Journal of CT and MRI

基　　金：陕西省重点研发计划(2017ZDCXL-SF-02-04-02)。

摘　　要：目的双源CT冠脉成像与12导联动态心电图在冠心病诊断及不良心脏事件预测中的应用价值研究。方法选取2021年10月至2023年10月在本院就诊的108例疑似冠心病,接受双源CT冠脉成像与12导联动态心电图患者作为研究对象,通过随访6个月,了解患者不良心脏事件(Major Adverse Cardiovascular Events,MACE)发生情况。分析双源CT冠脉成像与12导联动态心电图在冠心病诊断的应用价值。分析冠心病患者不良心脏事件的影响因素,采用ROC分析双源CT冠脉成像与12导联动态心电图预测冠心病患者不良心脏事件的应用价值。结果108例患者中,经冠状动脉造影诊断为冠心病患者为75例。以冠状动脉造影诊断结果作为标准,双源CT冠脉成像、12导联动态心电图与冠状动脉造影结果相比,Kappa值为0.723、0.409。双源CT冠脉成像诊断冠心病与冠状动脉造影结果Kappa值高于12导联动态心电图诊断Kappa值(P<0.05)。采用ROC分析冠脉钙化总积分、伴钙化斑块冠脉支数、伴软斑块冠脉支数、心肌缺血发作次数预测患者MACE的AUC分别为0.823、0.641、0.819、0.750,敏感度、特异度分别为93.9%/65.4%、89.8%/42.3%、71.4%/96.2%、100%/50%。结论双源CT冠脉成像和12导联动态心电图在冠心病诊断及不良心脏事件预测中都具有重要的应用价值。两者各有侧重,可相互补充提高冠心病诊断的准确性和预测不良心脏事件的敏感性。在临床实践中,建议根据患者的具体情况选择合适的检查方法,更好地评估患者的病情和预测不良心脏事件的发生。Objectiveto study the application value of dual-source CT coronary imaging and 12-lead dynamic electrocardiogram in the diagnosis of coronary artery disease and prediction of adverse cardiac events.Methods108 patients with suspected coronary artery disease,who received dual-source CT coronary imaging with 12-lead ambulatory electrocardiography,who attended our hospital from October 2021 to October 2023,were selected as the study subjects,and were followed up for 6 months to understand the occurrence of adverse cardiovascular events(Major Adverse Cardiovascular Events(MACE))in the patients.To analyse the value of dual-source CT coronary imaging and 12-lead ambulatory electrocardiography in the diagnosis of coronary artery disease.To analyse the influencing factors of adverse cardiac events in patients with coronary artery disease,and to analyse the application value of dual-source CT coronary imaging and 12-lead ambulatory electrocardiography in predicting adverse cardiac events in patients with coronary artery disease using ROC.ResultsAmong 108 patients,75 patients were diagnosed with coronary artery disease by coronary angiography.Using the diagnostic results of coronary angiography as the standard,the Kappa values of dual-source CT coronary imaging and 12-lead ambulatory electrocardiography compared with the results of coronary angiography were 0.723 and 0.409.The Kappa values of the diagnosis of coronary artery disease by dual-source CT coronary imaging and the results of coronary angiography were higher than that of the diagnostic Kappa value of 12-lead ambulatory electrocardiography(P<0.05).The AUC for predicting MACE in patients using ROC analysis of total coronary calcification score,number of coronary branches with calcified plaque,number of coronary branches with soft plaque,and number of episodes of myocardial ischemia were 0.823,0.641,0.819,and 0.750,with sensitivities and specificities of 93.9%/65.4%,89.8%/42.3%,and 71.4%/96.2%,respectively,100%/50%.ConclusionDual-source CT coronary imaging and 12-lea

关 键 词：双源CT冠脉成像 12导联动态心电图 冠心病 不良心脏事件 诊断 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病]