冠脉CTA对冠心病的诊断价值研究

Study on the diagnostic value of coronary CTA for coronary artery disease

目的 研究冠状动脉(冠脉)CT血管造影(CTA)对冠心病的临床诊断价值。方法 回顾性分析610例疑似冠心病患者的临床资料,均行冠脉CTA检查和冠脉造影检查。以冠脉造影诊断结果为金标准,分析冠脉CTA诊断冠心病结果及诊断价值,比较冠脉造影和冠脉CTA的诊断时间。结果 经冠脉造影检查确诊603例冠心病,病变1538处;经冠脉CTA检出598例冠心病,病变1533处。冠脉CTA病变检出率为99.67%。经冠脉CTA诊断冠心病的阳性预测值、阴性预测值、敏感度、特异度、准确度、约登指数、误诊率、漏诊率分别为99.67%、41.67%、98.84%、71.43%、98.52%、0.7027、28.57%、1.16%。冠脉CTA诊断时间(13.05±3.45)min短于冠脉造影的(35.44±8.65)min,差异有统计学意义(P<0.05)。结论 经冠脉CTA诊断冠心病的诊断结果与冠脉造影检查相比无明显差异,但能够实现无创诊断,且整体检出时间更短,可以为临床的诊断工作提供科学的参考。

Objective To study the clinical value of coronary CT angiography(CTA)for the diagnosis of coronary artery disease.Methods The clinical data of 610 patients with suspected of coronary heart disease were analyzed retrospectively,and coronary CTA and coronary angiography were performed.With the diagnosis result of coronary angiography as the gold standard,the results and diagnostic value of coronary CTA in the diagnosis of coronary heart disease were analyzed,and the diagnosis time of coronary angiography and coronary CTA was compared.Results Coronary angiography confirmed 603 cases of coronary heart disease with 1538 lesions,and coronary CTA detected 598 cases of coronary heart disease with 1533 lesions.The detection rate of coronary CTA was 99.67%.The positive predictive value,negative predictive value,sensitivity,specificity,accuracy,Youden's index,misdiagnosis rate,missed diagnosis rate were 99.67%,41.67%,98.84%,71.43%,98.52%,0.7027,28.57%,1.16%,respectively.The diagnostic time of coronary CTA(13.05±3.45)min was shorter than(35.44±8.65)min of coronary angiography,and the difference was statistically significant(P<0.05).Conclusion The diagnostic results of coronary CTA for the diagnosis of coronary artery disease are not significantly different compared with coronary angiography,but it can achieve non-invasive diagnosis with shorter overall detection time,which can provide scientific reference for clinical diagnosis.