CCTA和TET诊断冠心病的价值分析

Value of CCTA and TET in Diagnosis of Coronary Heart Disease

目的比较冠状动脉CT血管成像(CCTA)与运动平板试验(TET)对冠心病的诊断价值。方法收集2017年6月至2019年1月我院临床疑诊冠心病患者78例,均行CCTA、TET及CAG检查,以CAG结果为"金标准",评价CCTA与TET对冠心病的诊断效能。结果78例患者,经CAG证实冠心病46例,经TET诊断冠心病32例,经CCTA诊断冠心病43例。以CAG为"金标准",CCTA对冠心病诊断的敏感度为89.1%,特异度为93.8%,准确度为91.0%,阳性预测值为95.4%,阴性预测值为85.7%,均明显高于TET(50.0%、71.9%、59.0%、71.9%、50.0%),差异有统计学意义(P<0.05)。Kappa一致性检验显示,CCTA与CAG对各支冠状动脉诊断有着极好一致性,Kappa值均>0.75。结论CCTA对冠心病诊断的准确率明显高于TET,对于有典型症状的可疑患者应及早行CCTA检查。

Objective To compare the value of coronary CT angiography(CCTA)and treadmill exercise testing(TET)in the diagnosis of coronary heart disease.Methods 78 patients with clinically suspected coronary heart disease admitted to the hospital from June 2017 to January 2019 were selected.All of them underwent CCTA,TET,and CAG.With the results of CAG as the golden standard,the diagnostic efficiencies of CCTA and TET,for coronary heart disease were evaluated.Results In 78 patients,there were 46 patients,32 patients,and 43 patients with coronary heart disease diagnosed by CAG,TET,and CCTA,respectively.With CAG as the golden standard,the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of CCTA for the diagnosis of coronary heart disease(89.1%,93.8%,91.0%,95.4%,85.7%)were significantly higher than those of TET(50.0%,71.9%,59.0%,71.9%,50.0%)(P<0.05).Ka ppa consistency test showed that the consistency of CCTA with CAG was excellent for the diagnosis of coronary arteries,and the Kappa values were all larger than 0.75.Conclusion The accu racy of CCTA in the diagnosis of coronary heart disease is significantly higher than that of TET.For patients with typical sym ptoms,CCTA should be perfo rmed ea rly.