多种无创检查组合在冠心病诊断中的价值

被引：19

作者：

于海波 ^{[1
]}

韩雅玲 ^{[1
]}

荆全民 ^{[1
]}

刘海伟 ^{[1
]}

张磊 ^{[1
]}

霍勇 ^{[2
]}

张岩 ^{[2
]}

机构：

[1] 沈阳军区总医院心内科

[2] 北京大学第一医院心内科

来源：

现代生物医学进展 | 2014年 / 14卷 / 09期

关键词：

静息心电图(RECG); 发作心电图(AECG); 24小时动态心电图(Holter); 运动平板心电图(TET); 多层螺旋CT(MSCT); 核素心肌灌注显像(SPECT); 冠状动脉造影(CAG); 冠心病(CAD);

D O I：

10.13241/j.cnki.pmb.2014.09.016

中图分类号：

R541.4 [冠状动脉（粥样）硬化性心脏病（冠心病）];

学科分类号：

1002 ; 100201 ;

摘要：

目的:评价多种无创辅助检查组合对冠状动脉粥样硬化性心脏病(冠心病)辅助诊断价值,筛选有效的冠心病确诊和排除指标,初步确定优化的冠心病早期诊断策略。方法:回顾性分析6419例冠心病患者多项无创辅助检查结果(包括静息心电图、24小时动态心电图、负荷心电图、负荷核素心肌显像、16或64排CT冠状动脉成像),以冠状动脉造影阳性(至少一支主要冠状动脉或其主要分支的内径有≥50%的狭窄)为金标准,观察各种无创辅助检查组合对冠心病诊断的特异性、敏感性、误诊率、漏诊率、阳性预测值和阴性预测值。结果:多项无创辅助检查组合在冠心病的诊断中敏感性56.02-87.43%,特异36.13-87.61%,阳性预测值58.83-97.16%,阴性预测值30.21-73.36%,非介入手段中,敏感性和阴性预测值以动态心电图联合核素心肌灌注显像组最高,特异性和阳性预测值以动态心电图联合冠脉CT成像组最高。结论:辅助检查组合可作为无创性诊断、评价冠心病的重要方法,动态心电图可作为各级别医院冠心病筛查的基本及重要手段。

引用

页码：1668 / 1670+1656 +1656

页数：4

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