血管内超声判定不稳定斑块的敏感性与特异性及其可靠性研究

Study on sensitivity,specificity and reliability of unstable plaque determined by intravascular ultrasound

目的探讨血管内超声判定不稳定斑块的敏感性与特异性及其可靠性。方法选择2017年5月—2020年5月郑州市第七人民医院接治的80例冠心病患者,均行冠状动脉造影诊断,诊断完成后行血管内超声,其中脂质斑块患者为A组,纤维钙化斑块患者为B组,利用血管内超声对两组患者的斑块情况进行定量分析。结果急性冠状动脉综合征患者经血管内超声共明确诊断出37例脂质斑块患者,纤维钙化斑块患者43例,病理学诊断确认脂质斑块患者46例,纤维钙化斑块患者34例,检出率为80.43%,敏感度80.43%,特异性79.07%,准确率88.75%。A组患者脂核面积、脂核与斑块比例、偏心程度均大于B组(P<0.05),但是纤维帽厚度、面积狭窄率均小于B组(P<0.05),A、B两组患者的斑块大小无明显差异(P>0.05)。结论不稳定斑块患者的诊断过程中采取血管内超声诊断的准确率较为理想,对斑块电量数据测量进准,能够快速测量斑块的大小、形态及表面情况,快速给出鉴别,为临床治疗提供可靠依据。

Objective To investigate sensitivity,specificity and reliability of unstable plaque determined by intravascular ultrasound.Methods Totally 80 patients with coronary heart disease were selected and treated in our hospital from May 2017 to May 2020.All these patients accepted coronary angiography diagnosis and intravascular ultrasound successively,wherein patients with soft plaque were classified as group A,and patients with hard plaque were classified as group B,then the specific situations on plaque of patients from two groups were analyzed quantificationally via intravascular ultrasound.Results In all patients with acute coronary syndrome,37 patients with soft plaque and 43 patients with hard plaque were diagnosed definitely by virtue of intravascular ultrasound.In addition 46 patients with soft plaque and 34 patients with hard plaque were confirmed through pathological diagnosis,the detectable rate was 80.43%,sensitivity was 80.43%,specificity was 79.07%,and accuracy rate was 88.75%.The of lipid core,the ratio of lipid core to plaque,and the degree of decentration of group A were greater than those of group B(P<0.05),however,fiber cap thickness and area narrowing rate of group A were less than those of group B(P<0.05),meanwhile,there was no significant difference in plaque size between group A and group B(P>0.05).Conclusion Intravascular ultrasound diagnosis is suitable for patients with unstable plaques,which has high accuracy rate;besides,accurate measurement of plaque power data can determine size,shape and surface state of plaque rapidly,and perform rapid identification,providing reliable basis for clinical treatment.