摘要
目的：研究计算机断层摄影术冠状动脉（冠脉）造影（CTCA）在急性胸痛患者中诊断冠心病和评价冠脉病变程度的价值。方法：回顾性入选133例临床诊断为不稳定性心绞痛的急性胸痛患者，分别接受64排CTCA和冠脉造影检查。以定量冠脉造影（QCA）为诊断标准，评价CTCA诊断冠心病和冠脉病变程度的准确性。结果：CTCA诊断冠心病的敏感性93．4％，阳性预测值94．2％。Pearson相关分析示：CTCA和冠脉造影评价的冠脉直径狭窄程度显著相关（P〈0．001）。Logistic回归分析示，钙化程度是CTCA诊断冠心病敏感性的独立影响因素（RR=2．37，95％CI：1．35—4．18，P=0．003）。ROC曲线分析显示，钙化积分对预测冠脉三支血管存在≥50％或≥75％狭窄有预测作用，P均〈0．05。结论：CTCA在急性胸痛患者中对冠心病的筛查和冠脉病变程度的评价有较高价值。
Objective： To assess the diagnostic value of coronary artery disease （CAD） and coronary lesion by CT coronary angiography （CTCA） in patients with acute chest pain. Methods：We prospectively analyzed 1＂33 consecutive patients of unstable angina pectoris with acute chest pain. 64-slice CTCA and coronary angiography （CAG） were preformed in each patient, the result of quantitative coronary angiography was used as the standard to evaluate the diagnostic accuracy of CAD by CTCA. Results：The diagnostic sensitivity and the positive predictive value of CAD by CTCA were 93.4% and 94. 2% respectively. Pearson correlation analysis revealed a positive correlation of coronary stenosis degree between CTCA and CAG examination,P 〈 0. 001. Logistic regression analysis demonstrated that calcium score was an independent sensitivity factor for CAD diagnosis （ RR =2, 37,95% CI：1. 35 -4. 18,P =0. 003）. ROC curve indicated that severe coronary artery stenosis（ ≥50% or ≥75%） could be better predicted by measuring coronary artery calcium score for each individual coronary arteries （ P 〈 0.05）. Conclusion：CTCA has a high sensitivity for CAD diagnosis and high predictive value for measuring the severity of coronary lesion in patients with acute chest pain.
出处
《中国循环杂志》
CSCD
北大核心
2011年第2期101-104,共4页
Chinese Circulation Journal
