动态心电图联合CT血管成像对冠心病心肌缺血的诊断效能

Diagnostic Efficacy of Dynamic Electrocardiogram Combined with CT Angiography in the Diagnosis of Coronary Heart Disease Myocardial Ischemia

目的:探讨动态心电图(DCG)联合CT血管成像(CTA)对冠心病心肌缺血的诊断效能。方法:选取2020年1月—2023年1月盐城市第三人民医院收治的116例疑似冠心病心肌缺血患者作为研究对象,将冠状动脉造影(CAG)作为检验金标准,所有患者均进行DCG、CTA检查,比较DCG、CTA、DCG联合CTA诊断冠心病心肌缺血的敏感度、特异度、准确度、阳性预测值、阴性预测值。结果:116例疑似冠心病心肌缺血患者,CAG诊断冠心病心肌缺血阳性72例,DCG诊断阳性51例,CTA诊断阳性60例,经DCG联合CTA诊断阳性68例。三种检测方法诊断冠心病心肌缺血敏感度、准确度、阴性预测值比较,差异有统计学意义(P<0.05),且DCG联合CTA诊断冠心病心肌缺血敏感度、准确度、阴性预测值最高;但三种检测方法特异度、阳性预测值比较,差异无统计学意义(P>0.05)。结论:DCG联合CTA在冠心病心肌缺血的诊断上表现出高敏感度、准确度、阴性预测值,优于两者单一检测。

Objective:To explore the diagnostic efficacy of dynamic electrocardiogram(DCG)combined with CT angiography(CTA)in coronary heart disease myocardial ischemia.Method:A total of 116 patients with suspected coronary heart disease myocardial ischemia who treated in the Third People's Hospital of Yancheng City from January 2020 to January 2023 were selected as the study subjects.Coronary angiography(CAG)was considered the"gold standard"for diagnosis,all patients were underwent DCG and CTA examinations,and the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of DCG,CTA and DCG combined with CTA in the diagnosis of coronary heart disease myocardial ischemia were compared.Result:Among 116 patients with suspected coronary heart disease myocardial ischemia,72 cases were diagnosed as positive for coronary heart disease myocardial ischemia through CAG,51 cases were diagnosed positive by DCG,60 cases were diagnosed positive by CTA,and 68 cases were diagnosed positive by combined DCG and CTA.The sensitivity,accuracy and negative predictive values of three detection methods in the diagnosis of coronary heart disease myocardial ischemia were compared,and the differences were statistically significant(P<0.05),DCG combined with CTA had the highest sensitivity,accuracy,and negative predictive values in the diagnosis of coronary heart disease myocardial ischemia;however,there were no statistically significant differences in the specificity and positive predictive value of three detection methods(P>0.05).Conclusion:DCG combined with CTA showes high sensitivity,accuracy and negative predictive value in the diagnosis of coronary heart disease myocardial ischemia,which is better than single detection of two.