摘要
目的以ROC曲线法客观分析急诊超声心动图对心血管系统疾病的诊断价值。方法选取2016年1月至2017年1月绍兴第二医院急诊行床边超声心动图检查的81例心血管疾病患者为研究对象,以后续冠状动脉造影、介入或外科手术等为"金标准",ROC曲线分析急诊超声心动图对心血管疾病的诊断价值,计算各项诊断效能指数,分析超声心动图诊断结果与"金标准"结果间的一致性,比较常规心电图检查与超声心动图诊断结果间的差异性。结果 81例中67例经急诊超声心动图诊断为阳性,14例为阴性,急诊超声心动图诊断结果与"金标准"具有中度一致性(Kappa=0.764,P<0.01),对各具体疾病类型的诊断准确性比较,差异无统计学意义(P>0.05)。61例经常规心电图诊断为阳性,20例为阴性,诊断结果与"金标准"间一致性较差(Kappa=0.179,P>0.05)。ROC分析显示超声心动图诊断符合率为93.83%,敏感度为94.29%,特异度为90.91%,误诊率为9.09%,漏诊率为5.71%;诊断AUC为0.926。常规心电图诊断符合率为74.07%,敏感度为78.57%,特异度为45.45%,误诊率为54.55%,漏诊率为21.43%;诊断AUC为0.620,诊断效能低于超声心动图。超声心动图与常规心电图的检查反应时间、检查时间、诊断时间比较,差异均无统计学意义(P>0.05)。结论急诊超声心动图对心血管系统疾病具有较高的诊断价值,并且具有易于操作、检查诊断快捷以及准确性高的明显优势,在急诊心血管疾病的临床诊断中具有推广意义。
Objective To objectively analyze the diagnostic value of emergency echocardiography for cardiovascular diseases(CVD)by receiver operating characteristic(ROC)curve method.Methods From January 2016 to January 2017,81 patients with CVD were examined by emergency echocardiography in the Second Hospital of Shaoxing.The results of coronary angiography,intervention or surgical operation were regarded as gold standard,and those diagnostic efficiency indexes of emergency echocardiography for CVD were analyzed by ROC curve.The consistency between echocardiographic diagnostic results and gold standard results was analyzed.The difference between routine electrocardiogram examination and echocardiography diagnosis results were compared.Results Of the 81 cases,67 were diagnosed positive by emergency echocardiography and 14 were negative.The diagnostic results of emergency echocardiography had moderate consistency with the gold standard(Kappa=0.764,P<0.01).There was no significant difference in the accuracy rate of the specific disease types(P>0.05).Sixty-one cases were positive by routine electrocardiogram,20 were negative,and the diagnostic results were not consistent with the gold standard(Kappa=0.179,P>0.05).The ROC analysis showed that the diagnostic accuracy rate of echocardiography and routine electrocardiogram was 93.83%and 74.07%;the sensitivity was 94.29%and 78.57;the specificity was 90.91%and 45.45%;the misdiagnosis rate was 9.09%and 54.55%;the missed diagnosis rate was 5.71%and 21.43%;and the diagnostic area under curve(AUC)was 0.926 and 0.620,respectively.The diagnostic accuracy of emergency echocardiography for CVD was higher than that of routine electrocardiogram.There were no significant differences between echocardiography and routine electrocardiogram in test reaction time,examination time or diagnosis time(P>0.05).Conclusions Emergency echocardiography is of high diagnostic value for CVD,and has the obvious advantages of easy operation,quick diagnosis and high accuracy.It has great significance in the clinica
作者
骆华德
Luo Huade(Department of Emergency,the Second Hospital of Shaoxing,Shaoxing 312000,China)
出处
《中华医学超声杂志（电子版）》
CSCD
北大核心
2018年第6期445-449,共5页
Chinese Journal of Medical Ultrasound(Electronic Edition)
