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(P<0.05);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(P<0.05);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(P<0.05)。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。
Objective：To discuss the diagnostic value of echocardiography for coronary heart disease（CHD）.Method：A total of 1 271 cases of patients with coronary heart disease（CHD）was analyzed retrospectively.All cases were performed coronary angiography（CAG）and UCG.UCG took advantage of 16 left ventricular segmental method by edge detecting various ventricular segmental wall motion abnormalities,and then putting the results of coronary angiography as gold standard,to discuss the relationship between coronary lesions and ventricular wall motion abnormality detection rate.Result：1The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of echocardiography in the diagnosis of CHD were 56.1%,64.8%,57.8%,86.3% and27.1%.Besides,the sensitivity of angina pectoris group was 44.1%,while the sensitivity of myocardial infarction group was 77.1%.The sensitivities in myocardial infarction were significantly higher than those of angina pectoris and there was significant difference（P〈0.05）.2Coronary artery lesions were divided into single,double,three pathological changes.The sensitivity had a tendency to increase with the increased number of lesion artery,and there was significant difference（P〈0.05）;3The accuracy of the UCG in the diagnosis of coronary heart disease had a tendency to increase with narrow degree aggravating,the sensitivity went to the highest when blocking and there was significant difference（P〈0.05）.Conclusion：As a non-invasive examination,UCG in the diagnosis of coronary heart disease has important clinical value.The positive predictive value is as high as 86.3%,but the sensitivity and specificity is not high,and the negative predictive value is low,so it need comprehensive judgment in the clinical work.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2015年第4期440-442,共3页
Journal of Clinical Cardiology
关键词
超声心动图
冠状动脉造影
冠心病
室壁运动异常
echocardiography
coronary angiography
coronary heart disease
regional wall motion abnormality
