摘要
目的:探究颈动脉彩色多普勒超声检查联合动态心电图(AECG)在高龄冠心病(CHD)患者诊断及病情评估中的临床价值。方法:选取2018年3月至2020年3月就诊于湖南中医药高等专科学校第一附属医院的167例疑似CHD的高龄患者,进行颈动脉彩色多普勒超声检查与AECG检查,以冠状动脉造影(CAG)为"金标准",分析两种检查的灵敏度、特异度、准确度、阳性及阴性预测值、颈动脉内膜中层厚度(IMT)等情况。结果:颈动脉彩色多普勒超声联合AECG检查诊断CHD的特异度及阳性预测值高于单纯运用颈动脉彩色多普勒超声、AECG检查,差异具有统计学意义(P<0.05);冠状动脉病变支数越多,颈动脉彩色多普勒超声检查IMT值越高。结论:颈动脉彩色多普勒超声检查与AECG检查诊断高龄CHD患者灵敏度均良好,但特异度较低,二者联合使用能显著提高特异度及阳性预测值,为无创筛查高龄CHD患者提供了新思路。
Objective To explore the clinical value of carotid ultrasonography combined with active electrocardiography(AECG)in the diagnosis and evaluation of elderly patients with coronary heart disease(CHD).Methods A total of 167 elderly patients with suspected CHD who were admitted to the First Affiliated Hospital of Hunan College of Traditional Chinese Medicine from March 2018 to March 2020 were selected for carotid ultrasound and AECG examination.Coronary angiography(CAG)was regarded as the"gold standard".The sensitivity,specificity,accuracy,positive and negative predictive values,and carotid intima-media thickness(IMT)were analyzed.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of carotid artery ultrasonography were 90.81%,62.31%,79.4%,77.39%and 82.69%respectively.The sensitivity,specificity and accuracy of AECG were 77.55%,65.22%,72.45%,76.00%and 67.16%respectively.The specificity and positive predictive value of CAROTID ultrasonography combined with AECG in diagnosing CHD were higher than those of carotid ultrasonography combined with AECG alone(P<0.05).The higher the number of coronary artery lesions,the higher the IMT value of carotid ultrasonography.Conclusions Both carotid ultrasound and AECG have good sensitivity in the diagnosis of elderly PATIENTS with CHD,but their specificity is low.The combination of the two can significantly improve the specificity and positive predictive value,providing a new idea for non-invasive screening of elderly patients with CHD.
作者
胡伯媛
许厚本
HU Bo-yuan;XU Hou-ben(The First Affiliated Hospital of Hunan College of Traditional Chinese Medicine,Hunan Zhuzhou 412000)
出处
《深圳中西医结合杂志》
2021年第17期94-96,共3页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
关键词
冠心病
颈动脉彩色多普勒超声
动态心电图
Coronary heart disease
Color doppler ultrasound of carotid artery
Active electrocardiography
