联合开展彩色超声心动图检查与颈动脉彩色多普勒检查对冠心病的诊断效能探讨

Exploring the diagnostic efficacy of joint color echocardiography and carotid artery color Doppler examination for coronary heart disease

目的探究冠心病(CHD)患者应用彩色超声心动图与颈动脉彩色多普勒联合检查的诊断效能。方法选择天津市东丽医院2020年8月-2022年9月收治的86例疑似CHD患者,对所有患者均行彩色超声心动图检查和颈动脉彩色多普勒检查,以冠状动脉造影(CAG)检查结果为“金标准”,分析彩色超声心动图与颈动脉彩色多普勒检查结果,对比CHD阳性及阴性患者彩色超声心动图与颈动脉彩色多普勒检查结果;对比彩色超声心动图与颈动脉彩色多普勒单项及联合检查对CHD的诊断价值,并计算与CAG检查结果的一致性。结果86例疑似CHD患者中经CAG检查明确为CHD阳性68例,阴性18例;经彩色超声心动图检查检出CHD阳性61例,阴性25例;颈动脉彩色多普勒检出CHD阳性57例,阴性29例。CHD阳性患者心肌做功指数(Tei)及颈动脉内中膜厚度(IMT)均大于CHD阴性患者(P<0.05)。相比于单项检查,联合检查诊断CHD的灵敏度、准确度及阴性预测值均较高(P<0.05);彩色超声心动图与CAG检查结果一致性尚可(kappa值=0.600,P=0.000),颈动脉彩色多普勒与CAG检查结果一致性不佳(kappa值=0.398,P=0.000),联合检查一致性良好(kappa值=0.865,P=0.000)。结论CHD患者应用彩色超声心动图与颈动脉彩色多普勒联合检查具有较高的诊断价值,对CHD的诊断准确度较高,且与“金标准”CAG检查结果存在较高的一致性,能够为临床进一步明确诊断提供超声影像参考,值得临床推广应用。

Objective To explore the diagnostic efficacy of combined color echocardiography and carotid color Doppler examination in patients with coronary heart disease(CHD).Method 86 suspected CHD patients admitted to our hospital from August 2020 to September 2022 were selected,and all patients underwent color echocardiography and carotid artery color Doppler examination.The results of coronary angiography(CAG)were used as the"gold standard"to analyze the results of color echocardiography and carotid artery color Doppler examination.The results of color echocardiography and carotid artery color Doppler examination were compared between CHD positive and negative patients;compare the diagnostic value of color echocardiography with carotid artery color Doppler single and combined examinations for CHD,and calculate the consistency with the results of CAG examination.Results Among 86 suspected CHD patients,68 were confirmed positive for CHD and 18 were confirmed negative through CAG examination.61 cases of CHD were detected as positive and 25 cases as negative through color echocardiography examination;carotid artery color Doppler detected 57 cases of positive CHD and 29 cases of negative CHD.The myocardial work index(Tei)and carotid intima-media thickness(IMT)of CHD positive patients were higher than those of CHD negative patients(P<0.05).Compared to single examination,the sensitivity,accuracy,and negative predictive value of combined examination in diagnosing CHD are higher(P<0.05);the consistency between color echocardiography and CAG examination results is still acceptable(kappa value=0.600,P=0.000),while the consistency between carotid artery color Doppler and CAG examination results is poor(kappa value=0.398,P=0.000),and the consistency of the combined examination is good(kappa value=0.865,P=0.000).Conclusion The combined examination of color echocardiography and carotid artery color Doppler in CHD patients has high diagnostic value,high diagnostic accuracy,and high consistency with the"gold standard"CAG examination results.It is worthy of clinical promotion.