64排螺旋CT冠状动脉成像对女性及男性冠状动脉狭窄诊断价值的对比

Contrast about Diagnostic Value of 64-Detector Spiral Computed Tomography Coronary Angiography in Female and Male Patients with Coronary Artery Stenosis

目的评价64排螺旋CT冠状动脉成像(64-DSCTCA)对女性、男性冠状动脉狭窄的诊断价值是否相同。方法选择行心脏64-DSCTCA检查并同时行选择性冠状动脉造影检查怀疑为冠心病或已确诊为冠心病的男、女患者各75例。以冠状动脉造影结果作为金标准,分别计算64-DSCTCA诊断女性、男性冠心病(冠状动脉狭窄程度≥50%)、冠状动脉中度狭窄(狭窄程度50%~75%)、重度狭窄及完全闭塞(狭窄程度76%~100%)的灵敏度、特异度、阳性预测值、阴性预测值。采用统计学方法对比分析64-DSCTCA诊断女性、男性冠心病、冠状动脉中度狭窄、重度狭窄及完全闭塞的灵敏度、特异度、阳性预测值及阴性预测值是否不同。结果 64-DSCTCA诊断女性、男性冠心病的灵敏度、特异度、阴性预测值差异无统计学意义(P>0.05),诊断女性冠心病的阳性预测值低于男性(P<0.05)。64-DSCTCA诊断女性、男性冠状动脉中度狭窄的灵敏度、特异度、阳性预测值、阴性预测值差异无统计学意义(P>0.05)。64-DSCTCA诊断女性、男性冠状动脉重度狭窄及完全闭塞的灵敏度、特异度、阴性预测值差异无统计学意义(P>0.05),诊断女性冠状动脉重度狭窄及完全闭塞的阳性预测值低于男性(P<0.05)。结论 64-DSCTCA对女性、男性冠状动脉狭窄的诊断价值不尽相同,诊断女性冠心病、冠状动脉重度狭窄及完全闭塞的阳性预测值低于男性。

Aim To evaluate whether the value of 64-detector spiral computed tomography coronary angiography( 64-DSCTCA) is identical between female and male in diagnosis of patients with coronary artery stenosis. Methods75 female and 75 male patients with coronary artery disease( CAD) or suspected CAD were chosen,who had been examined with not only 64-DSCTCA but also coronary angiography( CAG). The result of CAG was regarded as the gold standard. The sensitivities,specificities,positive prediction values and negative prediction values of 64-DSCTCA were respectively calculated in diagnosis of female and male patients with CAD( coronary artery stenosis≥50%),coronary artery moderate stenosis( stenosis 50% ~ 75%),severe stenosis and occlusion( stenosis 76% ~ 100%). The aforementioned results were analyzed by statistical method,and contrasted between female and male. Results For the sensitivity,specificity,and negative prediction value of 64-DSCTCA in diagnosis of CAD,the differences were not statistically significant( P > 0. 05),but positive prediction value was lower in female than that in male( P < 0. 05). For the sensitivity,specificity,positive prediction value,and negative prediction value of 64-DSCTCA in diagnosis of coronary artery moderate stenosis,the differences were not statistically significant between female and male( P > 0. 05). For the sensitivity,specificity,and negative prediction value of 64-DSCTCA in diagnosis of coronary artery severe stenosis and occlusion,the differences were not statistically significant( P > 0. 05),but positive prediction value was lower in female than that in male( P< 0. 05). Conclusions Diagnostic value of 64-DSCTCA is different in female and male. Positive prediction value of 64-DSCTCA is lower in female than that in male for diagnosis of CAD,coronary artery severe stenosis and occlusion.