冠状动脉造影检查评价6种无创检查对冠心病的诊断价值

Coronary Angiography in evaluating the diagnostic function of six kinds of non-invasive Methods to Coronary Artery Disease

目的评价无创检查对冠心病的诊断价值。方法115例接受选择性冠状动脉造影的患者，在同期内（间隔〈1周）接受心电图，动态心电图，平板运动试验，核素心肌断层显像，超声心动图，颈动脉超声检查，将各项检查结果进行对比分析。结果6种无创检查诊断冠心病的敏感性分别为43．8％、60．0％、82．2％、93．2％、46．6％、79．5％，特异性分别为52．4％、57．0％、71．4％、54．8％、59．5％、69．1％，准确性分别为46．9％、59。1％、78．3％、79．1％、51．3％、75．7％。结论无创检查方法中核素心肌断层显像检查的敏感性最高，平板运动试验与颈动脉超声的敏感性次之，平板运动试验检查的特异性高于颈动脉超声和超声心动图，均为诊断冠心病的较好的方法，多种无创检查方法相结合可提高冠心病的检出率和准确性。

Objective To observe the diagnostic value of non-invasive methods for coronary artery disease. Methods 115 patients who received coronary angiography, were tested by ECG, Holter, Treadmill exercise, SPECT, echocardiography, and Carotid ultrasonography simultaneously. All the data were collected and compared. The specificity, sensitivity and accuracy of those methods were observed. Results The sensitivities in the diagnosis of coronary heart disease of ECG, Holter, SPECT, Echocardiography, Carotid ultrasonography were 43.8% 60%、82.2%、93.2%、46.6%、79.5%, respectively, and the specificities were 52.4%、57%、71.4%、54.8%、59.5%、and 69.1%, respectively. The accuracies were 46.9%、59.1%、78.3%、79.1%、51.3%、and 75.7%, respectively. Conclusion In six kinds of non-invasive methods, sensitivity of SPECT is highest, and then Treadmill exercise and carotid ultrasonography. The specificity of treadmill exercise is higher than Carotid ultrasonography and Echocardiography, therefore, the combination of SPECT、TET and carotid ultrasonography are more reasonable and valuable for the diagnosis of coronary heart disease.