危险因素的评估在冠心病临床诊断中的参考价值研究

Role of independent risk factors in clinical diagnosis of coronary disease

目的:探讨冠心病危险因素在诊断冠心病中的价值。方法:以选择性冠状动脉造影为金标准,对3355例临床诊断冠心病患者的主要冠心病危险因素(年龄、性别、糖尿病、高脂血症及高血压)和临床诊断符合率的关系进行分析。结果:3355例临床诊断冠心病的符合率为75.26%。无危险因素时冠心病临床诊断符合率仅为25%,有一个危险因素时为61.2%(P<0.001),冠心病危险因素越多,临床诊断符合率越高。患者年龄越大,符合率越高,误诊越少。男性、有糖尿病史、高脂血症患者符合率显著高于女性、无糖尿病、无高脂血症患者。尤其是≤50岁女性的临床诊断符合率仅为46.88%。高血压有无对诊断符合率无明显影响(P>0.05)。结论:冠心病整体危险因素评估对临床诊断冠心病有重要价值。应在了解冠心病整体危险因素基础上,评估临床表现和辅助检查结果,科学地作出冠心病诊断。

Objective： To investigate the role of independent risk factors in clinical diagnosis of coronary artery disease（ CAD）. Method： A total of 3 355 consecutive patients suspected of CAD were studied respectively. All patients underwent selective coronary angiography and received a survey of risk factors, including age, gender, diabetes, hyperlipemia and hypertension. Then the relations between different risk factors and clinical diagnostic accuracies were identified. Result： Compared with the coronary angiographic findings, the clinically diagnostic accuracies in CAD patients with 0, 1,2, 3,4 and 5 risk factors were 25.00%, 61.20%, 75.66 %, 80.20%, 85.34 % and 93.02 % respectively, while the general diagnostic accuracy was 75.26%. The clinically diagnosis was more accurate in aged patients, male ,patients with diabetes or hyperlipemia than their respective counterpart（ P 〈 0.001 ）. Hypertension had no significant impact on the diagnostic accuracy （ P 〉 0.05）. Conclusion： The CAD risk factors is of great significance in the clinical diagnosis of CAD.