颈部血管超声与心脏超声联合诊断老年冠心病的价值

Value of cervical vascular ultrasound combined with cardiac ultrasound in the diagnosis of coronary heart disease in elderly patients

目的分析颈部血管超声联合心脏超声在老年冠心病诊断中的应用价值。方法前瞻性抽取2022年1月至2022年12月漯河市中医院收治的128例疑似老年冠心病患者作为研究对象,所有患者均进行冠状动脉造影、颈部血管超声与心脏超声检查。以冠状动脉造影作为诊断"金标准",分析颈部血管超声与心脏超声联合诊断老年冠心病的价值。结果经冠状动脉造影诊断,128例疑似老年冠心病患者中,阳性122例,阴性6例;心脏超声检出阳性114例,阴性14例;与冠状动脉造影诊断结果比较,二者一致性一般(Kappa=0.465,P<0.001)。颈部血管超声联合心脏超声检出阳性120例,阴性8例;与冠状动脉造影诊断结果比较,二者具有较强的一致性(Kappa=0.849,P<0.001)。单独心脏超声与联合诊断的特异度、阳性预测值、阴性预测值比较,差异未见统计学意义(P>0.05);联合诊断的灵敏度与准确度高于心脏超声诊断,差异有统计学意义(P<0.05)。结论颈部血管超声联合心脏超声诊断与冠状动脉造影诊断具有较强的一致性,联合诊断可以提高对老年冠心病患者无创诊断的灵敏度与准确度,诊断效能较高。

Objective To analyze the application value of cervical vascular ultrasound combined with cardiac ultrasound in the diagnosis of elderly coronary heart disease.Methods A total of 128 suspected elderly patients with coronary heart disease who were admitted to Luohe Hospital of Traditional Chinese Medicine from January 2022 to December 2022 were selected as research objects prospectively.They all underwent cervical vascular ultrasound and echocardiography examinations.The results of coronary angiography were taken as the gold standard to analyze the value of cervical vascular ultrasound combined with echocardiography in the diagnosis of coronary heart disease.Results According to coronary angiography,122 cases were positive,and 6 cases were negative.Cardiac ultrasound detected out 114 positive cases and 14 negative cases.Cardiac ultrasound had a average consistency with coronary angiography in the diagnosis of coronary heart disease in elderly patients(Kappa=0.465,P<0.001).Cervical vascular ultrasound combined with cardiac ultrasound detected out 120 positive cases and 8 negative cases;cervical vascular ultrasound combined with cardiac ultrasound had a strong consistency with coronary angiography(Kappa=0.849,P<0.001).There was no statistical significant difference in the specificity,positive predictive value,and negative predictive value between cardiac ultrasound alone and cervical vascular ultrasound combined with cardiac ultrasound(P>0.05).The sensitivity and accuracy of cervical vascular ultrasound combined with cardiac ultrasound were higher than those of cardiac ultrasound alone,and the difference was statistically significant(P<0.05).Conclusions Cervical vascular ultrasound combined with cardiac ultrasound has a strong consistency with coronary angiography diagnosis,and the combined diagnosis can improve the sensitivity and accuracy of non-invasive diagnosis for elderly patients with coronary heart disease,with high diagnostic efficiency.