多层螺旋CT与超声心动图在诊断冠心病中的应用比较

Comparison of the Application of Multi-slice Spiral CT and Ultrasound Cardiographyin the Diagnosis of Coronary Heart Disease

目的对比分析64排螺旋CT冠脉造影(CTA)与超声心动图(UCG)在冠心病诊断中的价值。方法回顾性收集2016年6月-2017年12月我院收治的46例疑诊冠状动脉狭窄患者,均行CTA、UCG检查,并与冠状动脉造影(CAG)检查结果进行对照。结果 46例患者,CAG检出37例阳性,9例阴性;以CAG诊断结果为"金标准",CTA诊断CHD的准确度、敏感度、特异度、阳性预测值、阴性预测值分别为73.91%、75.68%、88.89%、93.33%、42.11%,均高于UCG的58.70%、56.77%、66.67%、87.50%、27.27%,但差异无统计学意义(P>0.05);两者联合检查诊断冠心病的准确度、敏感度分别为91.30%、91.89%,均明显高于单纯CTA或UCG检查,差异有统计学意义(P<0.05)。结论 CTA、UCUG对冠心病诊断均有较高价值,两者联合应用,可提高诊断准确度。

Objective To compare and analyze the value of 64-slice spiral CT coronary angiography（CTA） and ultrasound cardiography（UCG） in the diagnosis of coronary heart disease（CHD）. Methods 46 patients with suspected CHD who were admitted to the hospital from June 2016 to December 2017 were retrospectively collected. All of them underwent CTA and UCG, and the results were compared with those of coronary angiography（CAG）. Results In the 46 cases, 37 cases were positiveand 9 cases were negative detected by CAG. With diagnostic results of CAG as the golden standard, the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of CTA for CHD were 73.91%, 75.68%, 88.89%, 93.33% and 42.11%, respectively which were higher than those of UCG（58.70%, 56.77%, 66.67%, 87.50%, 27.27%）（P〈0.05）. The accuracy and sensitivity of the combined examination in diagnosing CHD were 91.30% and 91.89%, respectivelywhich were significantly higher than those of simple CTA or UCG（P〈0.05）. Conclusion CTA and UCUG are of great value in the diagnosis of CHD. The combined use of the two can improve the diagnostic accuracy.