ESE联合ExECG检查在PCI术后冠状动脉严重病变诊断中的效能

Efficacy of ESE combined with ExECG in diagnosis of severe coronary lesions after PCI

目的:探讨运动负荷超声心动图(ESE)联合运动心电图(ExECG)检查在经皮冠状动脉介入(PCI)术后冠状动脉严重病变诊断中的效能。方法:选取60例PCI术后疑似发生冠状动脉严重病变的患者为研究对象,均进行ESE、ExECG、冠状动脉造影检查。观察ESE、ExECG、冠状动脉造影检查诊断结果,以冠状动脉造影检查结果为金标准,比较ESE、ExECG单项及联合检查诊断PCI术后冠状动脉严重病变的灵敏度、特异度、准确度。结果:冠状动脉造影检查诊断PCI术后冠状动脉严重病变阳性54例,阴性6例;ESE单项检查诊断PCI术后冠状动脉严重病变的灵敏度为75.93%,特异度为83.33%,准确度为75.00%;ExECG单项检查诊断PCI术后冠状动脉严重病变的灵敏度为59.26%,特异度为66.67%,准确度为60.00%;ESE、ExECG联合检查诊断PCI术后冠状动脉严重病变的灵敏度为85.19%,特异度为50.00%,准确度为81.67%;ESE、ExECG联合检查诊断PCI术后冠状动脉严重病变的灵敏度和准确度均高于ExECG单项检查,差异有统计学意义(P<0.05)。结论:ESE、ExECG联合检查诊断PCI术后冠状动脉严重病变的灵敏度和准确度均高于ExECG单项检查。

Objective:To investigate efficacy of exercise stress echocardiography(ESE)combined with exercise electrocardiography(ExECG)in diagnosis of severe coronary lesions after percutaneous coronary intervention(PCI).Methods:60 patients with suspected severe coronary lesions after PCI were selected as the research subjects,and all of them underwent ESE,ExECG and coronary angiography.The diagnostic results of ESE,ExECG and coronary angiography were observed.Using the results of coronary angiography as the gold standard,the sensitivities,specificities and accuracies of single ESE examination,single ExECG examination and combined examination in the diagnosis of severe coronary lesions after PCI were compared.Results:54 positive cases and 6 negative cases of severe coronary lesions after PCI were diagnosed by coronary angiography.The sensitivity,specificity and accuracy of single ESE examination in the diagnosis of severe coronary lesions after PCI were 75.93%,83.33%and 75.00%,separately.The sensitivity,specificity and accuracy of single ExECG examination in the diagnosis of severe coronary lesions after PCI were 59.26%,66.67%and 60.00%,separately.The sensitivity,specificity and accuracy of the combined examination of ESE and ExECG in the diagnosis of severe coronary lesions after PCI were 85.19%,50.00%and 81.67%,separately.The sensitivity and the accuracy of combined ESE and ExECG in the diagnosis of severe coronary lesions after PCI were higher than those of single ExECG examination,and the differences were statistically significant(P<0.05).Conclusions:The sensitivity and the accuracy of combined ESE and ExECG in the diagnosis of severe coronary lesions after PCI are higher than those of single ExECG examination.