超声心动图、冠状动脉CT血管成像联合诊断冠状动脉粥样硬化性心脏病患者冠状动脉斑块稳定性及狭窄程度中的应用价值  

Application Value of Echocardiography and Coronary CT Angiography in the Diagnosis of Coronary Plaque Stability and Stenosis in Patients with Coronary Atherosclerotic Heart Disease

作　　者：杨锦 杨明礼 朱双剑 YANG Jin;YANG Mingli;ZHU Shuangjian(Department of Radiology,Tianzhu County People's Hospital,Qiandongnan 556600,Guizhou,China)

机构地区：[1]天柱县人民医院放射科,贵州黔东南556600

出　　处：《世界复合医学(中英文)》2025年第3期162-167,共6页World Journal of Complex Medicine

摘　　要：目的 分析超声心动图、冠状动脉CT血管成像(coronary computed tomography angiography,CCTA)联合诊断冠状动脉粥样硬化性心脏病(简称冠心病)患者冠状动脉斑块稳定性及狭窄程度的价值。方法 选取2022年4月—2024年4月天柱县人民医院收治的80例冠心病患者,所有患者均行超声心动图、CCTA检查,以冠状动脉造影(coronary angiography,CAG)为金标准,分析超声心动图、CCTA联合诊断冠状动脉斑块稳定性及狭窄程度的效能及符合率。结果 80例冠心病患者共完成267处血管狭窄段检查,CAG共检出91处狭窄,超声心动图共检出78处狭窄,CCTA共检出80处狭窄,超声心动图联合CCTA共检出88处狭窄。超声心动图、CCTA及联合诊断与CAG均具有较高的一致性(kappa=0.853、0.871、0.958)。超声心动图联合CCTA诊断冠心病患者冠状动脉狭窄程度的灵敏度、准确度、阴性预测值均高于超声心动图、CCTA单独诊断,差异均有统计学意义(P均<0.05)。超声心动图、CCTA联合诊断重度狭窄冠状动脉符合率高于超声心动图、CCTA单独诊断,差异有统计学意义(P<0.05);但超声心动图、CCTA单独及联合诊断轻度狭窄及中度狭窄的符合率比较,差异均无统计学意义(P均>0.05)。超声心动图、CCTA联合诊断软斑块的符合率为100.00%(33/33),高于超声心动图的81.82%(27/33)及CCTA的90.91%(30/33),差异有统计学意义(χ2=8.919,P=0.012)。但超声心动图、CCTA单独及联合诊断钙化斑块及混合斑块的符合率比较,差异均无统计学意义(P均>0.05)。结论 超声心动图联合CCTA能有效检出冠心病患者的冠状动脉狭窄程度与斑块稳定情况,具有一定的临床应用价值。Objective The value of echocardiography and coronary computed tomography angiography(CCTA) in the diagnosis of coronary plaque stability and stenosis in patients with coronary heart disease(CHD)was analyzed.Methods A total of 80 patients with coronary heart disease admitted to Tianzhu County People's Hospital from April 2022 to April 2024 were selected.All patients underwent echocardiography and CCTA examination.Coronary angiography(CAG) was used as the gold standard to analyze the efficacy and coincidence rate of echocardiography and CCTA in the diagnosis of coronary plaque stability and stenosis.Results A total of 267 vascular stenosis segments were examined in 80 patients with coronary heart disease.A total of 91 stenosis segments were detected by CAG,78 stenosis segments were detected by echocardiography,80 stenosis segments were detected by CCTA,and 88 stenosis segments were detected by echocardiography combined with CCTA.Echocardiography,CCTA and combined diagnosis had high consistency with CAG(kappa=0.853,0.871,0.958).The sensitivity,accuracy and negative predictive value of echocardiography combined with CCTA in the diagnosis of coronary artery stenosis in patients with coronary heart disease were higher than those of the echocardiography,CCTA alone,and the differences were statistically significant(all P<0.05).The coincidence rate of echocardiography combined with CCTA in the diagnosis of severe stenosis coronary artery was higher than that of the echocardiography,CCTA alone,and the difference was statistically significant(P<0.05).However,there were no significant differences in the coincidence rate of echocardiography,CCTA alone and combined diagnosis of mild stenosis and moderate stenosis(both P>0.05).The coincidence rate of echocardiography combined with CCTA in the diagnosis of soft plaque was 100.00%(33/33),which was higher than 81.82%(27/33) of echocardiography and 90.91%(30/33) of CCTA,and the difference was statistically significant(χ2=8.919,P=0.012).However,there were no significant differences

关 键 词：冠状动脉粥样硬化性心脏病 冠状动脉 超声心动图 冠状动脉CT血管成像 

分 类 号：R54[医药卫生—心血管疾病]