冠状动脉CTA、UCG诊断CHD心肌缺血的临床意义  

Clinical significance of coronary artery CTA and UCG in diagnosing myocardial ischemia in CHD

作　　者：刘琳 LIU Lin(Department of Ultrasound,Luming Lake Hospital,Central Hospital of Xuchang,Xuchang,Henan,461000,China)

机构地区：[1]许昌市中心医院鹿鸣湖院区超声科,河南许昌461000

出　　处：《新疆医学》2024年第10期1247-1250,共4页Xinjiang Medical Journal

摘　　要：目的研究冠状动脉CT血管造影(computed tomography angiography,CTA)、超声心动图(ultrasonic cardiogram,UCG)诊断冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CHD)心肌缺血的临床意义。方法选取2019年3月~2022年2月我院CHD患者104例,均行冠状动脉CTA和UCG检查,以冠状动脉造影(coronary angiography,CAG)为“金标准”,统计冠状动脉CTA和UCG单独诊断和联合诊断CHD心肌缺血的诊断结果和诊断效能,分析预测值,比较不同方法对冠状动脉狭窄程度的检出率。结果二者联合诊断灵敏度、特异度、准确度较冠状动脉CTA诊断和UCG诊断高,漏诊率、误诊率较冠状动脉CTA诊断和UCG诊断低(P<0.05);二者联合诊断阳性预测值、阴性预测值较冠状动脉CTA诊断和UCG诊断高(P<0.05);104例CHD患者中,共发现122支血管病变,二者联合检查狭窄程度≥50%的检出率较冠状动脉CTA高(P<0.05)。结论冠状动脉CTA联合UCG诊断CHD心肌缺血的灵敏度、特异度、准确度较单一诊断高,且能减少漏诊、误诊的发生,提升阳性预测值和阴性预测值。Objective To study the clinical significance of coronary artery computed tomography angiography(CTA)and ultrasonic cardiogram(UCG)in the diagnosis of coronary atherosclerotic heart disease(CHD)myocardial ischemia.Methods A total of 104 patients with CHD admitted to our hospital from March 2019 to February 2022 were included.All patients underwent coronary artery CTA and UCG examinations.Coronary angiography(CAG)was used as the"gold standard"for diagnosis.The diagnostic results and diagnostic performance of coronary artery CTA and UCG,both individually and in combination,in diagnosing myocardial ischemia in CHD were statistically analyzed,and predictive values were calculated.The detection rates of different methods for the degree of coronary artery stenosis was compared.Results The sensitivity,specificity,and accuracy of the combined diagnosis were higher than those of coronary artery CTA alone and UCG alone.The missed diagnosis rate and misdiagnosis rate were lower than those of coronary CTA and UCG(P<0.05).The positive predictive value and negative predictive value of the combined diagnosis were higher than those of coronary artery CTA alone and UCG alone(P<0.05).Among 104 CHD patients,a total of 122 vascular lesions were found,and the detection rate of stenosis degree≥50%by combining the two was higher than that by coronary artery CTA(P<0.05).Conclusion The sensitivity,specificity and accuracy of coronary CTA combined with UCG in the diagnosis of myocardial ischemia in CHD are higher than those of single diagnosis,and can reduce the occurrence of missed diagnosis and misdiagnosis,and improve the positive predictive value and negative predictive value.

关 键 词：冠状动脉粥样硬化性心脏病 心肌缺血 冠状动脉CT血管造影 超声心动图 

分 类 号：R445.2[医药卫生—影像医学与核医学]