256-MSCTA联合颈动脉超声筛查冠状动脉粥样硬化对冠心病的预测效能分析  

Analysis of the Predictive Efficacy of 256-MSCTA Combined with Carotid Ultrasound in Screening Coronary Atherosclerosis for Coronary Heart Disease

作　　者：梁耘 莫健姣 杨静爱 吴英宁[1] 李保生[1] 黄昌辉[1] LIANG Yun;MO Jian-jiao;YANG Jing-ai;WU Ying-ning;LI Bao-sheng;HUANG Chang-hui(Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]右江民族医学院附属医院,广西百色533000

出　　处：《罕少疾病杂志》2025年第2期69-72,共4页Journal of Rare and Uncommon Diseases

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200399)。

摘　　要：目的 分析256层螺旋CT血管造影(256-MSCTA)联合颈动脉超声筛查冠状动脉粥样硬化对冠心病的预测效能。方法 回顾性选取2017年1月至2019年12月在本院接受治疗的63例冠心病患者资料,调取全部患者的冠状动脉造影(CAG)、256-MSCTA与颈动脉超声资料,对比CAG与256-MSCTA检查参数结果的差异性;以CAG为“金标准”,分析256-MSCTA对冠脉狭窄分级与“金标准”的一致性,分析256-MSCTA、颈动脉超声与二者联合对于冠心病的预测价值及预测效能指标:敏感度、特异性;对比0级冠脉狭窄与1~4级冠脉狭窄患者颈动脉中膜厚度(IMT)并分析两者的相关性;对比256-MSCTA下冠脉斑块钙化与非钙化患者的冠脉斑块CT值与颈动脉斑块CT值并分析其相关性。结果 63例患者共检出病变冠脉段103段,256-MSCTA对冠脉狭窄程度的诊断结果与“金标准”间具有较高一致性(P<0.05);CTA与CAG检查EEM面积、MLA、PA、PB、EI、RI均未见统计学差异(P>0.05);256-MSCTA、二者联合诊断结果与“金标准”间具有高度一致,颈动脉超声具有较高一致性(P<0.05);经ROC曲线分析联合诊断的预测价值最高(AUC=0.992,P<0.05);本组资料中0级冠脉狭窄的共39例、1~4级狭窄的共24例;冠脉狭窄1~4级的患者IMT高于0级,冠脉狭窄程度与IMT间具有中度相关性(P<0.05);本组患者中冠脉斑块非钙化29例,钙化34例;钙化斑块患者CT值均高于非钙化,冠脉斑块CT值与颈动脉斑块CT值具有高度相关性(P<0.05)。结论 256-MSCTA联合颈动脉超声筛查冠状动脉粥样硬化能够为冠心病的预测提供准确性参考,且颈动脉斑块与冠脉斑块的钙化程度及颈动脉与冠脉狭窄程度均具有明确相关性,超声筛查颈动脉情况能够辅助提高冠心病的诊断准确性。Objective To analyze the predictive efficacy of 256 slice spiral CT angiography(256-MSCTA)combined with carotid ultrasound in screening coronary Atherosclerosis for coronary heart disease.Methods 63 patients with coronary heart disease who received treatment in our hospital from January 2017 to December 2019 were retrospectively selected.Coronary angiography(CAG),256-MSCTA,and carotid ultrasound data were collected from all patients,and the differences in the results of CAG and 256-MSCTA examination parameters were compared.Using CAG as the gold standard,analyze the consistency between 256-MSCTA in grading coronary artery stenosis and the gold standard.Analyze the predictive value and predictive efficacy indicators of 256-MSCTA,carotid ultrasound,and their combination for coronary heart disease:sensitivity,specificity.Compare the carotid artery medial thickness(IMT)between patients with 0-grade coronary artery stenosis and those with 1-4 grade coronary artery stenosis,and analyze the correlation between the two;Compare the CT values of coronary plaques and carotid plaques in patients with calcified and non calcified coronary plaques under 256-MSCTA,and analyze their correlation.Results A total of 103 segments of the diseased coronary artery were detected in 63 patients,and the diagnostic results of 256-MSCTA for the degree of coronary stenosis showed high consistency with the gold standard(P<0.05).There was no significant difference in EEM area,MLA,PA,PB,EI,RI between CTA and CAG examinations(P>0.05).The diagnostic results of 256-MSCTA and their combination were highly consistent with the gold standard,and carotid artery ultrasound showed high consistency(P<0.05).The Receiver operating characteristic analysis showed that the combined diagnosis had the highest predictive value(AUC=0.992,P<0.05).In this group of data,there were 39 cases of 0-grade coronary artery stenosis and 24 cases of 1-4 grade stenosis.The IMT of patients with coronary artery stenosis grades 1-4 is higher than that of grade 0,and there is a mod

关 键 词：冠心病 冠状动脉狭窄 颈动脉超声 动脉粥样硬化斑块 256层螺旋CT血管造影 

分 类 号：R541.4[医药卫生—心血管疾病]