超声心动图对冠心病的诊断价值

发布时间：2018-06-12 15:30

本文选题：超声心动图 + 冠状动脉造影　；参考：《临床心血管病杂志》2015年04期

【摘要】：目的:探讨超声心动图(ultrasonic cardiography,UCG)对冠心病的诊断价值。方法:回顾性分析1271例冠心病患者,全部病例均行冠脉造影(CAG)及UCG。UCG利用左室16节段法通过多切面检测各室壁节段性运动异常,以CAG结果为金标准,探讨冠脉病变与节段性室壁运动异常检出率的关系。结果:1UCG诊断冠心病的敏感性为56.1%,特异性为64.8%,准确性为57.8%,阳性预测值为86.3%,阴性预测值为27.1%。其中心绞痛组的敏感性为44.1%,而心肌梗死组为77.1%。心肌梗死组的敏感性均显著高于心绞痛组,差异有统计学意义(P0.05);2冠脉病变分为单支、双支、3支病变,随着病变支数的增加,诊断的敏感性有所提高,差异有统计学意义(P0.05);3UCG诊断冠心病的准确性随着狭窄程度的加重而提高,当闭塞时敏感性最高,差异有统计学意义(P0.05)。结论:作为无创性的检查,UCG诊断冠心病有重要的临床价值,其阳性预测值高达86.3%,但敏感性、特异性不高,阴性预测值低,在临床工作中需综合判断。
[Abstract]:Objective: to evaluate the diagnostic value of echocardiographic echocardiography (UCG) in coronary heart disease (CHD). Methods: 1271 patients with coronary heart disease were analyzed retrospectively. All patients underwent coronary angiography (CAG) and UCG. UCG was used to detect segmental motion abnormalities of each ventricular wall with 16 segments of left ventricle. The results of CAG were regarded as the gold standard. To investigate the relationship between coronary artery lesion and segmental ventricular wall motion abnormality. Results the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and negative predictive value were 56.1, 64.8, 57.8, 86.3 and 27.1, respectively. The sensitivity of angina pectoris group was 44.1 and that of myocardial infarction group was 77.1. The sensitivity of myocardial infarction group was significantly higher than that of angina pectoris group. The accuracy of the diagnosis of coronary heart disease (CHD) was improved with the severity of stenosis, and the sensitivity was the highest when the coronary artery was occluded, and the difference was statistically significant (P 0.05). Conclusion: as a noninvasive examination, UCG has important clinical value in the diagnosis of coronary heart disease. The positive predictive value of UCG is as high as 86.3, but its sensitivity, specificity and negative predictive value are not high, so it is necessary to judge comprehensively in clinical work.
【作者单位】：广西医科大学第六附属医院;玉林市第一人民医院心内科;广西医科大学第一附属医院心内科;
【分类号】：R540.45;R541.4

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