心脏彩色超声与颈动脉超声联合检查对冠心病的诊断价值  

Diagnostic value of color Doppler echocardiography combined with carotid artery ultrasound on coronary heart disease

作　　者：魏玲杰 WEI Lingjie(Clinical Physiology Department,Anyang District Hospital,Anyang Henan 455000,China)

机构地区：[1]濮阳市安阳地区医院功能科,河南安阳455000

出　　处：《实用心电与临床诊疗》2025年第1期85-88,93,共5页PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT

摘　　要：目的探究心脏彩色超声(简称心脏彩超)联合颈动脉超声对冠心病的诊断价值。方法纳入90例疑似冠心病患者,均行心脏彩超及颈动脉超声检查。以冠状动脉造影结果为金标准,对比冠心病组(造影结果阳性)及非冠心病组(造影结果阴性)患者的超声参数,分析各超声指标在不同病变支数冠心病患者中的变化,并评估心肌做功指数(简称Tei指数)、斑块积分、颈动脉内中膜厚度(intima-media thickness,IMT)单项及三项指标联合检测对冠心病的诊断价值。结果冠心病组Tei指数、斑块积分、IMT值均明显高于非冠心病组(均P<0.01)。在52例冠心病患者中,单支病变30例,双支病变14例,多支病变8例。冠心病不同病变支数亚组的Tei指数、斑块积分、IMT比较,差异均有统计学意义(均P<0.01),且多支病变组患者Tei指数、斑块积分、IMT均显著高于双支及单支病变组患者(均P<0.05)。ROC曲线分析显示,上述三项超声指标中,IMT诊断冠心病的AUC、约登指数、敏感性以及特异性最高;而将三项指标联合应用于冠心病诊断时,AUC、敏感性均明显高于各指标单一诊断。结论心脏彩超联合颈动脉超声检查,有助于判断患者冠状动脉病变程度,利于提升冠心病的诊断效能,具有较高的推广应用价值。Objective To explore the diagnostic value of color Doppler echocardiography combined with carotid artery ultrasound on coronary heart disease(CHD).Methods A total of 90 cases suspected with CHD were included,and all underwent color Doppler echocardiography and carotid artery ultrasound examinations.Taking coronary angiography results as the gold standard,we compared the ultrasound parameters of patients between the CHD group(with positive angiography results)and the non-CHD group(with negative angiography results).We also analyzed the changes of each ultrasound parameter in CHD patients with different numbers of diseased coronary arteries.The diagnostic value of myocardial work index(Tei index),plaque score,intima-media thickness(IMT),and the combination of the above three indexes for CHD were all assessed.Results In the CHD group,the values of Tei index,plaque score,and IMT were all significantly higher than those in the non-CHD group(all P<0.01).Among the 52 patients with CHD,there were 30 cases with single-vessel disease,14 cases with doublevessel disease,and 8 cases with multi-vessel disease.There were statistically significant differences in Tei index,plaque score,and IMT among CHD patients of subgroups with different numbers of diseased coronary arteries(all P<0.01);and the values of the above indexes in the multi-vessel lesion subgroup were all significantly higher than those in the double-or single-vessel lesion subgroups(all P<0.05).ROC curve analysis showed that the AUC,Youden index,sensitivity,and specificity of IMT in the diagnosis of CHD was the highest among the above three ultrasound indicators;the values of AUC and sensitivity of the combination of the above three indexes were both significantly higher than those of any single index for the diagnosis of CHD.Conclusion The combination of color Doppler echocardiography and carotid artery ultrasound examinations help to determine the degree of coronary artery disease,and improve the diagnostic efficiency of CHD.It has relatively high value of popular

关 键 词：冠心病 心脏彩色超声 颈动脉超声 准确度 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]