CT血管成像联合12导联动态心电图在冠心病诊断中的应用
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摘要
目的探究CT血管成像联合12导联动态心电图(AECG)对冠心病的诊断价值。方法选择2015年7月至2018年1月我院心血管内科收治的疑似冠心病的患者92例作为研究对象,所有患者均行多层螺旋CT及12导联AECG检查,并经冠状动脉造影(CAG)证实,以CAG诊断结果为金标准,计算MSCT、12导联AECG及两者联合诊断冠心病的灵敏度、特异度、阳性预测值、阴性预测值及准确率。结果 MSCT诊断冠心病的灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为86.79%、87.18%、86.95%、90.19%、82.93%;AECG诊断冠心病的诊断灵敏度、特异度、准确度、阳性预测值、阴性预测值分别为79.24%、84.61%、81.52%、87.50%、75.00%;两者联合诊断准确度显著高于MSCT及12导联AECG,差异具统计学意义(P﹤0.05)。结论CT血管成像联合12导联动态心电图可提高冠心病诊断准确性,可在临床上推广使用。
Objective To investigate the diagnostic value of CT angiography combined with 12-lead dynamic electrocardiogram(AECG) for the diagnosis of coronary heart disease. Methods A total of 92 patients with suspected coronary heart disease in our department from July 2015 to January 2018 were selected. All patients underwent multislice spiral CT and 12-lead AECG, confirmed by coronary angiography(CAG), taking CAG diagnosis results as the gold standard,the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of coronary heart disease by MSCT, 12-lead AECG and their combined diagnosis were calculated. Results The sensitivity, specificity,accuracy, positive predictive value and negative predictive value of coronary heart disease by MSCT diagnosis were 86.79%, 87.18%, 86.95%, 90.19% and 82.93%, respectively, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of coronary heart disease by AECG diagnosis were 79.24%, 84.61%, 81.52%, 87.50%, and75.00%, respectively. The combined diagnosis accuracy was significantly higher than that of MSCT and 12-lead AECG(P<0.05). Conclusion CT angiography combined with 12-lead dynamic electrocardiogram can improve the diagnostic accuracy of coronary heart disease and has potential to be promoted clinically.
Objective To investigate the diagnostic value of CT angiography combined with 12-lead dynamic electrocardiogram(AECG) for the diagnosis of coronary heart disease. Methods A total of 92 patients with suspected coronary heart disease in our department from July 2015 to January 2018 were selected. All patients underwent multislice spiral CT and 12-lead AECG, confirmed by coronary angiography(CAG), taking CAG diagnosis results as the gold standard,the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of coronary heart disease by MSCT, 12-lead AECG and their combined diagnosis were calculated. Results The sensitivity, specificity,accuracy, positive predictive value and negative predictive value of coronary heart disease by MSCT diagnosis were 86.79%, 87.18%, 86.95%, 90.19% and 82.93%, respectively, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of coronary heart disease by AECG diagnosis were 79.24%, 84.61%, 81.52%, 87.50%, and75.00%, respectively. The combined diagnosis accuracy was significantly higher than that of MSCT and 12-lead AECG(P<0.05). Conclusion CT angiography combined with 12-lead dynamic electrocardiogram can improve the diagnostic accuracy of coronary heart disease and has potential to be promoted clinically.
引文
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[1 0]王士芳.平板运动试验和1 2导联动态心电图对心肌缺血性冠心病的诊断价值[J].现代中西医结合杂志,2016,25(12):1 346-1 348.
[11]张文杰,司茶,杨璐.动态心电图与超声心动图诊断冠心病无症状性心肌缺血的价值比较[J].现代仪器与医疗,2011,10(4):24-25.
[12]于海波,韩雅玲,荆全民,等.多种无创检查组合在冠心病诊断中的价值[J].现代生物医学进展,2014,14(9):1668-1670.
[2]赵雪梅,李家俊,刘亚欣,等.多层螺旋CT血管造影在评价冠状动脉粥样硬化性心脏病患者心肌缺血程度中的价值[J].中国临床保健杂志,2017, 5(6):693-696.
[3]王建军,陶黎,赵红,等.128层螺旋C T头颈部血管成像评估急性脑梗死患者颈动脉狭窄的临床价值[J].中国CT和MRI杂志,2 016,14(7):37-39.
[4]Vestberg A R,Tidholm A,Ljungvall I. Twenty-four-hour ambulatory electrocardiography characterization of heart rhythm in Vipera berusenvenomed dogs[J]. Acta Veter inaria Scandinavica,2017,59(1):28.
[5]冯小智.多层螺旋CT血管成像在冠心病诊断中的应用[J].山西医药杂志,2016, 45(17):1997-1999.
[6]杨志强,袁牧.不同程度冠状动脉狭窄的CT影像学特点及临床意义研究[J].中国CT和MRI杂志,2017,15(3):51-53.
[7] Hasselbalch R B, Engs t rom T,Pries-Heje M,et a l.Coronary risk stratification of patients undergoing surgery for valvular heart disease[J]. International Journal of Cardiology,2017,227(1 3):37-42.
[8]丁辉.6 4排螺旋C T冠脉成像(CTA)在冠心病诊断中的应用价值分析[J].中国实验诊断学,2016, 1 1(2):224-226.
[9] Rodriguez F H,Moodie D S,Neeland M,et a l. Identifying arrhythmias in adults with congenital heartdisease by 24-h ambulatory electrocardiography[J].Pediatric Cardiology, 2012,33(4):591-595.
[1 0]王士芳.平板运动试验和1 2导联动态心电图对心肌缺血性冠心病的诊断价值[J].现代中西医结合杂志,2016,25(12):1 346-1 348.
[11]张文杰,司茶,杨璐.动态心电图与超声心动图诊断冠心病无症状性心肌缺血的价值比较[J].现代仪器与医疗,2011,10(4):24-25.
[12]于海波,韩雅玲,荆全民,等.多种无创检查组合在冠心病诊断中的价值[J].现代生物医学进展,2014,14(9):1668-1670.