分析比较冠状动脉CT血管成像和平板运动实验在冠心病诊断中的应用

Analysis and comparison of coronary CT angiography and treadmill exercise test in the diagnosis of coronary artery disease

目的分析比较冠状动脉CT血管成像和平板运动实验在冠心病诊断中的应用效果。方法 620例疑似冠心病患者纳入研究,采用平板运动试验方式(440例)或冠状动脉CT血管成像技术(180例)对其进行检查,以冠状动脉造影(CAG)结果为金标准,对比二者诊断效果。结果冠状动脉CT血管成像灵敏度为91.67%,特异度为66.67%,阳性预测值为84.62%,阴性预测值为80.00%,诊断符合率为83.33%;平板运动试验灵敏度为72.73%,特异度为40.91%,阳性预测值为55.17%,阴性预测值为60.00%,诊断符合率为56.82%;冠状动脉CT血管成像灵敏度、特异度、阴性预测值、阳性预测值、诊断符合率明显高于平板运动试验,差异具有统计学意义(P<0.05)。结论和平板运动试验对比,冠状动脉CT血管成像技术应用于冠心病的检出率更高,但是平板运动试验更加安全、廉价、实用,二者均可作为临床诊断冠心病的方式,应当根据患者的实际情况选择合适的方式进行诊断。

Objective To analyze and compare the application effect of coronary CT angiography and treadmill exercise test in the diagnosis of coronary artery disease. Methods A total of 620 suspected coronary artery disease patients were taken into study, and they were all examined by treadmill exercise test （440 cases） and coronary CT angiography technique （180 cases）. Coronary angiography （CAG） results were used as the gold standard to compare the diagnostic effects of the two tests. Results Coronary CT angiography had sensitivity as 91.67%, specificity as 66.67%, positive predictive value as 84.62%, negative predictive value as 80%, and the diagnostic coincidence rate as 83.33%. The treadmill exercise test had sensitivity as 72.73%, specificity as 40.91%, positive predictive value as 55.17%, negative predictive value as 60%, and diagnostic coincidence rate as 56.82%. Coronary CT angiography had obviously higher sensitivity, specificity, negative predictive value, positive predictive value and diagnostic coincidence rate than treadmill exercise test, and their difference had statistical significance （/＇〈0.05）. Conclusion Compared with treadmill exercise test, coronary CT angiography is more effective in the detection of coronary heart disease, but the treadmill exercise test is more safe, cheap and practical. Both two tests can be used as a clinical way to diagnose coronary heart disease, and appropriate test should be chose according to actual situation of patients.