摘要
目的探讨多层螺旋CT对飞行人员冠心病的临床诊断价值。方法纳入29例临床怀疑冠心病的飞行人员,在我院接受心脏多层螺旋CT(multi-slice spiral computed tomography,MSCT)检查和冠状动脉血管造影术(coronary angiography,CAG)检查,以CAG结果为对照标准,分析MSCT诊断冠状动脉狭窄的敏感性、特异性、阳性预测值(positive predictive value,PPV)和阴性预测值(negative predictive value,NPV),比较两种检查方法的差异。结果 29例飞行人员均成功接受MSCT检查和CAG检查。MSCT检查发现5例飞行人员冠脉正常;19例飞行人员有不同程度冠脉血管狭窄,其中1例合并冠状动脉心肌桥;5例飞行人员仅有冠状动脉心肌桥形成。轻度狭窄的节段20个,中度狭窄的节段9个,重度狭窄的节段5个。以CAG结果为对照标准,MSCT诊断冠脉节段狭窄的敏感性、特异性、PPV、NPV分别为73.7%、99.5%、93.3%、97.4%,MSCT诊断冠脉狭窄的敏感性、特异性、PPV、NPV分别为79.2%、95.7%、82.6%、94.6%。结论 MSCT是冠心病诊断的一种无创检查方法,可较准确地判断血管壁斑块情况并评估狭窄程度,在飞行人员冠心病诊断中具有较高的临床价值。
Objective To explore the clinical value of multi-slice spiral computed tomography in the diagnosis of coronary heart disease （CHD） in pilots. Methods Twenty nine pilots with suspected CHD in our hospital underwent multi-slice spiral computed tomography （MSCT） and the coronary angiography （CAG）. The sensitivity, specificity, positive predictive value （PPV） and negative predictive value （NPV） of MSCT in the diagnosis of coronary artery stenosis were analyzed and compared with CAG results. Results All pilots received MSCT and CAG. MSCT showed normal coronary artery in 5 cases, myocardial bridge in 5 cases and coronary artery stenosis at different level in 19 cases with one case complicated by myocardial bridge. Meanwhile, MSCT showed 20 segments of mild stenosis, 9 segments of moderate stenosis and 5 segments of severe stenosis in 29 pilots. Comparing to CAG results, the sensitivity, specificity, PPV and NPV of MSCT in the diagnosis of coronary artery stenosis and segment stenosis were 73.7%, 99.5%, 93.3%, 97.4% and 79.2%, 95.7%, 82.6%, 94.6%, respectively. Conclusion MSCT is a noninvasive method for the diagnosis of CHD. The plaque on the vessel wall and the stenosis of coronary artery can be accurately detected by MSCT, which has a high clinical value in the diagnosis of CHD in pilots.
作者
陈诗婷
孙津津
牟宗阳
殷雪娇
郑军
罗惠兰
CHEN Shiting SUN Jinjin MOU Zongyang YIN Xuejiao ZHENG Jun LUO Huilan(Department of Cardiology, Air Force General Hospital, Beijing 100142, China Guizhou Medical University, Guiyang 550004, Guizhou Province, China Department of Aircrew, Air Force General Hospital, Beijing 100142, China Cardiovascular Ward of Cadres, Air Force General Hospital, Beijing 100142, China)
出处
《解放军医学院学报》
CAS
2017年第7期611-614,共4页
Academic Journal of Chinese PLA Medical School
基金
部委级资助项目
全军"十二五"重点项目(BWS11J054)~~
