64层螺旋CT冠状动脉成像在胸痛患者冠状动脉病变诊断中的价值分析

Analysis on value of 64-slice spiral CT coronary angiography in the diagnosis of coronary artery lesions in patients with chest pain

目的探讨64层螺旋CT冠状动脉成像(CTCA)在胸痛患者冠状动脉病变诊断中的价值。方法选取2018年2月~2019年2月来我院诊治的40例疑似冠心病患者作为研究对象,所有患者均行64层螺旋CTCA和冠状动脉造影SCA,以选择性冠脉造影(SCA)的诊断结果作为金标准,评价64层螺旋CTCA检查方式的诊断价值。结果64层螺旋CTCA检查诊断冠状动脉不同程度狭窄的特异性、敏感性、阳性预测值、阴性预测值均较高;64层螺旋CTCA检查冠状动脉轻度狭窄、中度狭窄和重度狭窄的符合率分别为69.74%、93.75%、92.31%,三组组间差异有统计学意义(P<0.05);中、重度狭窄诊断符合率均明显高于轻度狭窄(P<0.05),中、重度狭窄诊断符合率差异无统计学意义(P>0.05)。结论64层螺旋冠状动脉成像检查技术对于胸痛患者冠状动脉病变及血管狭窄程度有较高的诊断价值,可作为冠状动脉病变疾病的检查技术在临床推广应用。

Objective To explore the value of 64-slice spiral CT coronary angiography(CTCA)in the diagnosis of coronary artery lesions in patients with chest pain.Methods 40 with suspected coronary heart disease who were treated in our hospital from February 2018 to February 2019 were selected as research objects.All patients underwent 64-slice spiral CTCA and coronary angiography SCA.The diagnostic result of selective coronary angiography(SCA)was used as the gold standard to evaluate the diagnostic value of 64-slice spiral CTCA.Results The specificity,sen sitivity,positive predictive value and negative predictive value of 64-slice spiral CTCA examination in the diagnosis of coronary artery stenosis of different degrees were all higher.The coincidence rate of 64-slice spiral CTCA for mild,moderate and severe coronary artery stenosis was 69.74%,93.75%and 92.31%,respectively.The difference among the three groups was significant,with statistical significance(P<0.05).The diagnostic coincidence rate of moderate and severe stenosis was significantly higher than that of mild stenosis(P<0.05).There was no significant difference in coincidence rate between moderate and severe stenosis(P>0.05).Conclusion 64-slice spiral coronary angiography has a high diagnostic value for coronary artery lesions and vascular stenosis in patients with chest pain.It can be used as a screening technique for coronary artery disease,which can be promoted and applied in clinical practice.