256排螺旋CT冠状动脉成像联合血清Hcy、NT-proBNP诊断冠状动脉粥样硬化性心脏病的价值分析

Value Analysis of 256-Slice Spiral CT Coronary Artery Imaging Combined with Serum Hcy and NT-proBNP in the Diagnosis of Coronary Atherosclerotic Heart Disease

目的:探讨256排螺旋CT冠状动脉成像联合血清同型半胱氨酸(Hcy)、氨基末端B型钠尿肽原(NT-proBNP)诊断冠状动脉粥样硬化性心脏病(冠心病)的临床价值。方法:选取我院2018年1月~2021年12月期间收治的102例冠心病患者作为研究组,另取同期健康体检者100例作为对照组。分别比较两组256排螺旋CT冠状动脉成像阳性率及成像特征,检测并对比两组血清Hcy、NT-pro BNP水平。采用受试者工作特征(ROC)曲线分析256排螺旋CT冠状动脉成像联合血清Hcy、NT-proBNP诊断冠心病的效能。结果:研究组256排螺旋CT冠状动脉成像阳性率高于对照组,且轻度、中度以及重度狭窄人数占比均高于对照组(P<0.05)。研究组91例阳性患者中73例为右优势型冠状动脉,3例为左优势型冠状动脉,15例为均势型冠状动脉;32例为单支病变,50例为双支病变,9例为多支病变;17处位于右冠状动脉,5处位于左主干,38处位于左前降支,31处位于左旋支。研究组血清Hcy、NT-proBNP水平均明显高于对照组(P<0.05)。ROC曲线分析结果显示:256排螺旋CT冠状动脉成像联合血清Hcy、NT-pro BNP诊断冠心病的曲线下面积为0.863,高于上述三项单独检测的0.673、0.649、0.655。结论:256排螺旋CT冠状动脉成像联合血清Hcy、NT-proBNP可有效提高冠心病的诊断效能。

Objective:To investigate the clinical value of 256-slice spiral CT coronary artery imaging combined with serum homocysteine(Hcy)and amino-terminal B-type natriuretic peptide(NT-proBNP)in the diagnosis of coronary atherosclerotic heart disease(coronary heart disease).Methods:A total of 102 patients with coronary heart disease who were admitted to our hospital from January 2018 to December 2021 were selected as the study group,and another 100 healthy subjects during the same period were selected as the control group.The positive rate and imaging characteristics of 256-slice spiral CT coronary artery imaging were compared between the two groups,and serum Hcy and NT-proBNP levels were detected and compared between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the efficacy of 256-slice spiral CT coronary artery imaging combined with serum Hcy and NT-probNP in the diagnosis of coronary heart disease.Results:The positive rate of 256-slice spiral CT coronary artery imaging in the study group was higher than that in the control group,and the proportion of mild,moderate and severe stenosis was higher than that in the control group(P<0.05).Of the 91 positive patients in the study group,73 cases were right dominant coronary artery,3 cases were left dominant coronary artery and 15 cases were balanced coronary artery.32 cases were single vessel lesions,50 cases were double vessel lesions and 9 cases were multi vessel lesions.17 were located in the right coronary artery,5 in the left main artery,38 in the left anterior descending artery and 31 in the left circumflex artery.The serum Hcy and NT-proBNP levels in the study group were significantly higher than those in the control group(P<0.05).ROC curve analysis showed that the area under the curve of 256-slice spiral CT coronary artery imaging combined with serum Hcy and NT-proBNP in the diagnosis of coronary heart disease was 0.863,which was higher than 0.673,0.649 and 0.655 detected separately by the above three items.Conclusion:256-slice spiral CT coronary artery imaging combined with serum Hcy and NT-proBNP can effectively improve the diagnostic efficiency of coronary heart disease.