摘要
目的探讨颈动脉、头臂干分叉处(BOBT)内中膜厚度与主动脉瓣(AV)、主动脉窦管交界处(STJ)钙化联合检测在冠心病(CAD)预测诊断中的价值。方法选择2015年4月至2017年12月江苏省人民医院及江苏省钟山干部疗养院收治的临床怀疑冠心病的住院患者146例,行冠脉造影及超声检查。根据冠脉造影结果分为观察组(CAD,106例)及对照组(非CAD,40例),根据颈部及心脏超声检查,记录颈动脉斑块Crouse积分、斑块数、BOBT内中膜厚度及AV、STJ是否钙化。根据病变支数及Gensini评分分为单支组(30例)、多支组(76例)及低Gensini评分组(34例)、高Gensini评分组(72例)。结果观察组患者颈动脉斑块Crouse评分、斑块数、BOBT内中膜厚度及AV、STJ钙化阳性率均高于对照组(P <0. 05);高Gensini评分组及多支组颈动脉斑块Crouse评分、斑块数、BOBT内中膜厚度及AV钙化阳性率均高于低Gensini评分组及单支组(P <0. 05);高Gensini评分组及多支组STJ钙化阳性率与低Gensini评分组及单支组比较无差异(P> 0. 05)。不同指标联合检测的灵敏度为96. 2%、特异度为35. 0%、阳性预测值为94. 4%、阴性预测值为77. 8%。结论颈动脉、BOBT内中膜厚度及AV、STJ钙化联合检测能发挥不同检测项目的优势,补充单一检测项的不足,以通过无创、经济的诊断方法评估CAD严重程度。
Objective To investigate the predictive value of combined detection of intima-media thickness of carotid artery and brachiocephalic trunk bifurcation（BOBT） and the calcification of aortic valve（AV） and aortic sinotubular junction（STJ） in the diagnosis of coronary artery disease（CAD）. Methods A total of 146 patients who were admitted in Jiangsu Provincial People＇s Hospital and Jiangsu Zhongshan Cadre Sanatorium from April 2015 to December 2017 and suspected as CAD in clinic and receiving coronary angiography and ultrasound examination were selected. According to the results of coronary angiography,the patients were divided into observation group（n = 106） and control group（n = 40）. According to the ultrasound examination of the neck and heart,Crouse integral and number of carotid artery plaques,intima-media thickness of BOBT and calcification of AV and STJ were recoded. According to the branch number of lesions and Gensini scoring,the patients were divided into single branch group（n = 30） and multi branch group（n = 76）,low Gensini score group（n = 34） and high Gensini score group（n = 72）. Results The Crouse score and number of carotid plaques,intimamedia thickness of BOBT and the positive rate of AV and STJ calcification in observation group were significantly higher than those in control group（all P〈0. 05）. Crouse score and number of carotid plaques,intima-media thickness of BOBT and the positive rate of AV calcification in high Gensini score group and multi branch group were significantly higher than those in low Gensini score group and single branch group,respectively（all P〈0. 05）. There were no significant differences in the positive rate of STJ calcification between high Gensini score group and low Gensini score group and between multi branch group and single branch group（all P〈0. 05）. Sensitivity,specificity,positive predictive value and negative predictive value were 96. 2%,35. 0%,94. 4% and 77. 8%,respectively for the joint detection of different indexes.Conclusion The combined detection of intima-media thickness of carotid artery and BOBT and the calcification of AV and STJ can give the best play to advantages to every detection item,supplement the shortcomings of single detection item and help clinicians assess the severity of CAD through non-invasive and economic diagnostic methods.
作者
陈召兄
刘圣
叶新华
王道猛
CHEN Zhao-xiong , LIU Sheng, YE Xin-hua, WANG Dao-meng(Department of Ultrasound, First Affiliated Hospital of Nanfing Medical University, Nanjing, Jiangsu 210029, China)
出处
《中国临床研究》
CAS
2018年第9期1170-1173,共4页
Chinese Journal of Clinical Research
关键词
冠心病
颈动脉
头臂干分叉处动脉
内中膜
主动脉瓣
主动脉窦管交界处动脉
钙化
Coronary artery disease
Carotid artery
Brachiocephalic trunk bifurcation artery
Intima-media
Aortic valve
Aortic sinotubular junction artery
Calcification
