超声心动图检查在冠心病节段性室壁运动异常诊断中的价值

Value of echocardiography in diagnosis of segmental wall motion abnormalities in coronary heart disease

目的:探讨超声心动图检查在冠状动脉粥样硬化性心脏病(冠心病)节段性室壁运动异常诊断中的价值。方法:选取76例疑似冠心病节段性室壁运动异常患者为研究对象,均先后进行超声心动图、冠脉造影检查,以冠脉造影检查结果为金标准,比较冠脉造影检查与超声心动图检查诊断心脏异常的检出率,观察超声心动图检查诊断冠心病节段性室壁运动异常的效能(灵敏度、特异度、准确度、阳性预测值和阴性预测值),采用Kappa检验观察超声心动图检查与冠脉造影检查诊断冠心病节段性室壁运动异常的一致性。结果:冠脉造影检查结果显示,76例疑似冠心病节段性室壁运动异常患者阳性50例,阴性26例;冠脉造影检查与超声心动图检查左心房内径异常检出率、左心室舒张末期内径异常检出率和右心室流出道异常检出率比较,差异均无统计学意义(P>0.05);超声心动图检查诊断冠心病灵敏度为100.00%(50/50),特异度为92.31%(24/26),准确度为97.37%(74/76),阳性预测值为96.15%(50/52),阴性预测值为100.00%(24/24);Kappa检验结果显示,超声心动图检查与冠脉造影检查诊断冠心病节段性室壁运动异常具有较好的一致性(Kappa=0.940,P<0.05)。结论:超声心动图检查和冠脉造影检查诊断冠心病节段性室壁运动异常具有较好的一致性。

Objective:To explore value of echocardiography in diagnosis of segmental wall motion abnormalities in coronary heart disease.Methods:76 patients with suspected segmental wall motion abnormalities of coronary heart disease were selected as the research objects,and all of them underwent echocardiography and coronary angiography.Using the coronary angiography results as the gold standard,the detection rate of coronary angiography and echocardiography in the diagnosis of the cardiac abnormalities were compared.The the efficacies(sensitivity,specificity,accuracy,positive predictive value and negative predictive value)of the echocardiography in the diagnosis of the segmental wall motion abnormalities in coronary heart disease were observed.The Kappa test was used to test the consistency of echocardiography and coronary angiography in the diagnosis of segmental wall motion abnormalities in coronary heart disease.Results:The coronary angiography showed that among the 76 patients with suspected segmental wall motion abnormalities of coronary heart disease,50 cases were positive and 26 cases were negative.There were no significant differences in the detection rates of abnormal left atrial inner diameter,abnormal left ventricular end-diastolic diameter and abnormal right ventricular outflow tract between coronary angiography and echocardiography(P>0.05).The sensitivity of echocardiography in the diagnosis of coronary heart disease was 100.00%(50/50),the specificity was 92.31%(24/26),the accuracy was 97.37%(74/76),the positive predictive value was 96.15%(50/52),and the negative predictive value was 100.00%(24/24).The Kappa test showed that there was good consistency between echocardiography and coronary angiography in the diagnosis of segmental wall motion abnormalities in coronary heart disease(Kappa=0.940,P<0.05).Conclusions:There is a good consistency between echocardiography and coronary angiography in the diagnosis of segmental wall motion abnormalities in coronary heart disease.