心脏超声联合颈部血管超声诊断老年冠心病的价值分析

Value of Cardiac Ultrasound Combined with Cervical Vascular Ultrasound in the Diagnosis of Elderly Coronary Heart Disease

目的研究老年冠心病应用心脏超声、颈部血管超声联合诊断的有效性。方法选取2022年3月—2023年4月东莞市长安医院收治的75例疑似老年冠心病患者,以彩色多普勒超声心动图检查结果为金标准,依次进行心脏超声诊断、颈部血管超声诊断、联合诊断的方式,评估联合诊断方式的应用价值。结果以彩色多普勒超声心动图检查结果为金标准,共有70例颈动脉狭窄,心脏超声灵敏度为91.45%、特异度为40.00%、准确度为88.00%,颈部血管超声诊断灵敏度为90.00%、特异度为20.00%、准确度为85.33%,联合诊断灵敏度为98.57%、特异度为60.00%、准确度为96.00%。以彩色多普勒超声心动图检查结果为金标准,32例患者属于颈动脉轻度狭窄,28例患者属于中度狭窄,10例患者属于重度狭窄,联合诊断的符合率分别为90.60%、96.40%、80.00%,高于单独诊断符合率,差异有统计学意义(χ^(2)=10.231、9.887、12.342,P<0.05)。结论老年冠心病患者的诊断,要大力推广心脏超声联合颈部血管超声诊断的方法,更好地保障诊断准确率,尽快治疗患者和干预患者,保障患者生活质量。

Objective To investigate the effectiveness of combined diagnosis of cardiac ultrasound and cervical vascular ultrasound in elderly patients with coronary heart disease.Methods 75 suspected elderly patients with coronary heart disease admitted to Dongguan Chang'an Hospital from March 2022 to April 2023 were selected,and the results of color Doppler echocardiography were used as the gold standard.Cardiac ultrasound diagnosis,cervical vascular ultrasound diagnosis and combined diagnosis were performed successively to evaluate the application value of combined diagnosis.Results A total of 70 cases of carotid artery stenosis were identified using color Doppler echocardiography findings as the gold standard.The sensitivity of cardiac ultrasound was 91.45%,specificity was 40.00%and accuracy was 88.00%,the diagnostic sensitivity of carotid vascular ultrasound was 90.00%,specificity was 20.00%and accuracy was 85.33%,and the combined diagnostic sensitivity was 98.57%,specificity was 60.00%and accuracy was 96.00%.Using the color Doppler echocardiography results as the gold standard,32 patients belonged to mild carotid artery stenosis,28 patients belonged to moderate stenosis,and 10 patients belonged to severe stenosis,and the compliance rates of the combined diagnosis were 90.60%,96.40%,and 80.00%,respectively,which were higher than the compliance rates of the individual diagnosis,and the differences were statistically significant(χ^(2)=10.231,9.887,12.342,P<0.05).Conclusion In the diagnosis of elderly patients with coronary heart disease,it is necessary to vigorously promote the method of cardiac ultrasound combined with cervical vascular ultrasound diagnosis to better ensure the diagnostic accuracy,treat and intervene patients as soon as possible,and ensure the quality of life of patients.