心脏超声联合颈部血管超声诊断老年冠心病的准确性评价

Accuracy Evaluation of Cardiac Ultrasound Combined with Cervical Vascular Ultrasound to Diagnose Coronary Heart Disease in the Elderly

目的探讨心脏超声联合颈部血管超声检查在冠心病诊断中的价值。方法选取2021年3月—2023年3月湖北省直属机关医院收治的200例疑似冠心病患者为研究对象,所有患者均实施心脏超声、颈部血管超声检查,以血管造影检查结果为金标准,分析单一与联合诊断的检出情况、诊断效能、狭窄检出情况。结果心脏超声检出真阳性121例、真阴性36例,心脏超声联合颈部血管超声检出真阳性149例、真阴性46例。心脏超声联合颈部血管超声检查的灵敏度为98.03%(149/152)、特异度为95.83%(46/48)、准确度为97.50%(195/200),高于心脏超声检查的79.61%(121/152)、75.00%(36/48)、78.50%(157/200),差异有统计学意义(χ^(2)=25.952、8.362、34.185,P均<0.05)。以血管造影检查结果金标准,心脏超声+颈部血管超声检查检出的狭窄程度符合率均高于心脏超声,差异有统计学意义(P均<0.05)。结论在老年冠心病诊断中心脏超声、颈部血管超声联合诊断准确率高。

Objective To explore the value of cardiac ultrasound combined with cervical vascular ultrasound in the diagnosis of coronary heart disease.Methods A total of 200 patients with suspected coronary heart disease admitted to Hubei Provincial Government Hospital from March 2021 to March 2023 were selected as the research objects.All patients underwent cardiac ultrasound and cervical vascular ultrasound.The results of angiography were used as the gold standard to analyze the detection,diagnostic efficacy and stenosis detection of single and combined diagnosis.Results 121 cases of true positive and 36 cases of true negative were detected by echocardiography,149 cases of true positive and 46 cases of true negative were detected by cardiac ultrasound combined with cervical vascular ultrasound.The sensitivity,specificity and accuracy of cardiac ultrasound combined with cervical vascular ultrasound were 98.03%(149/152),95.83%(46/48)and 97.50%(195/200),which were higher than 79.61%(121/152),75.00%(36/48)and 78.50%(157/200)of cardiac ultrasound,and the differences were statistically significant(χ^(2)=25.952,8.362,34.185,all P<0.05).According to the gold standard of angiography results,the coincidence rate of stenosis degree detected by cardiac ultrasound+cervical vascular ultrasound were higher than that of cardiac ultrasound,and the differences were statistically significant(all P<0.05).Conclusion The accuracy of combined diagnosis of cardiac ultrasound and cervical vascular ultrasound in the diagnosis of coronary heart disease in the elderly is high.