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目的对CT冠脉血管成像(CTA)技术诊断心绞痛患者的临床价值进行评估。方法选择该院心血管内科收治的69例心绞痛患者作为研究对象,分别采用CTA和冠状动脉造影(CAG)对患者进行检查,以CAG作为参照,对CTA诊断心绞痛的应用价值进行评价。结果 CAG检查共诊断182支冠脉血管无狭窄,诊断<50%狭窄程度31支血管、50%~75%血管管腔狭窄程度53支、>75%程度狭窄血管10支;CTA检查诊断179支冠脉血管无狭窄,诊断<50%狭窄程度38支血管、50%~75%血管管腔狭窄程度49支、>75%程度狭窄血管10支;CTA和CAG诊断阳性结果一致的有85支血管,诊断阴性结果一致的有170支血管,二种检查方法检测结果的一致性分析Kappa=0.832,P=0.000<0.001,CTA诊断冠脉狭窄的灵敏度:90.43%、特异度:93.41%、漏诊率:9.57%、误诊率:6.59%。CTA与CAG诊断LM、LAD、LCX、RCA狭窄的结果进行比较分析差异均无统计学意义(P>0.05)。结论对于心绞痛患者应用CTA检查诊断冠脉病变的结果与CAG具有极高的一致性,但是CTA具有无创、操作简单的优势,可以作为临床上对疑似心绞痛患者的一种筛查手段应用。
Objective To evaluate the clinical value of CT coronary angiography (CTA) in the diagnosis of angina pectoris. Methods Sixty-nine patients with angina pectoris admitted to our hospital were enrolled in this study. Patients were examined by CTA and CAG respectively. CAG was used as a reference to evaluate the diagnostic value of CAG in the diagnosis of angina pectoris. Results There were no coronary stenosis in 182 coronary arteries in CAG examination, 31 vessels were diagnosed as <50% stenosis, 53 vessels were stenosed in 50% -75%, 10 vessels were stenosed> 75%, 179 were diagnosed by CTA No coronary stenosis, diagnosis of <50% stenosis of 38 vessels, 50% to 75% of the degree of vascular stenosis 49,> 75% stenosis of the vessel 10; CTA and CAG diagnosis consistent with the results of 85 blood vessels , The diagnostic negative results were consistent with 170 blood vessels, the consistency of the two test methods test results Kappa = 0.832, P = 0.000 <0.001, CTA diagnosis of coronary artery stenosis sensitivity: 90.43%, specificity: 93.41%, misdiagnosis rate : 9.57%, misdiagnosis rate: 6.59%. There was no significant difference between the CTA and CAG in the diagnosis of LM, LAD, LCX and RCA stenosis (P> 0.05). Conclusions The results of CTA diagnosis of coronary artery disease in patients with angina pectoris are highly consistent with those of CAG. However, CTA has the advantages of noninvasive and simple operation, and can be used as a screening method in patients with suspected angina pectoris.