盐酸去甲乌药碱负荷心肌灌注显像与负荷心电图对冠心病诊断价值的对比研究

Comparative Study on the Diagnosis Values of Stress Myocardial Perfusion Imaging and Stress Electrocardiogram with Higenamine Hydrochloride in Coronary Heart Disease

目的比较盐酸去甲乌药碱(HG)负荷心肌灌注显像(MPI)和负荷心电图(ECG)对冠心病的诊断价值。方法 70例患者同时完成HG负荷核素MPI及冠脉造影(CAG)检查,在心肌灌注负荷试验过程中观察ECG变化,并与同期负荷MPI和冠脉造影结果作对比。结果以CAG结果为金标准,HG负荷MPI诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值、准确性分别为55.8%、92.6%、92.3%、56.8%、70%,HG负荷ECG诊断冠心病的敏感性、特异性、阳性预测值、阴性预测值、准确性分别为74.4%、29.6%、62.7%、42.1%、57.1%。MPI的特异性和阳性预测值明显高于ECG(P<0.01),敏感性、阴性预测值、准确性两者统计学差异不大(P>0.05)。结论 HG可作为负荷MPI和负荷ECG药物来诊断冠心病,且HG负荷MPI的特异性要优于HG负荷ECG。

Objective To compare the diagnosis values of stress myocardial perfusion imaging （MPI） and stress electrocardiogram （ECG） with Higenamine Hydrochloride （HG） in coronary heart disease （CHD）. Methods In the process of stress test with HG for myocardial perfusion, observe the ECG changes of 70 patients who simultaneously underwent the examinations of both stress MPI with HG and coronary angiography （CAG）, and then compare the results with those of stress MPI and CAG. Results With the results of CAG as the gold standard, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of stress MPI in diagnosing CHD were 55.8%, 92.6%, 92.3%, 56.8%and 70%, respectively, while those of stress ECG were 74.4%, 29.6%, 62.7%, 42.1% and 57.1%, respectively. Thus, the speciifcity and positive predictive value of stress MPI in diagnosing CHD were obviously higher than those of stress ECG （P〈0.01） while there was no signiifcant difference in the sensitivity, negative predictive value and accuracy between stress MPI and stress ECG in diagnosing CHD （P〉0.05）. Conclusion HG can be used as a drug for stress MPI and stress ECG to diagnose CHD while the speciifcity of stress MPI is higher than that of stress ECG.