静息心电图、胸痛症状与冠脉CTA筛查冠心病的临床价值

目的 探讨静息心电图、胸痛症状与256层螺旋CT冠脉成像筛查冠心病的诊断价值。方法 收集入院后接受静息心电图、256层螺旋CTA检查共计68例非急症胸痛疑似冠心病患者的相关资料，所有患者30 d内均进行CAG检查。以CAG诊断为标准，采用ROC曲线分析静息心电图、胸痛症状与冠脉CTA筛查冠心病的诊断价值。结果 256层螺旋CTA诊断冠心病的ROC曲线下面积为0.73（P＜0.05），其诊断敏感性为96.55%，特异性为50.00%，诊断价值大于静息心电图（AUC=0.50，P＞0.05）和胸痛症状（AUC=0.51，P＞0.05）。结论 256层螺旋CTA筛查冠心病有较高的诊断价值；静息心电图、胸痛症状对冠心病的筛查存在明显的局限性。

Clinical Value of Resting Electrocardiogram,Chest Pain Symptoms and Coronary CTA Screening for Coronary Heart Disease

Abstract:Objective To investigate the diagnostic value of resting electrocardiogram, chest pain and 256-slice spiral CT coronary angiography for coronary heart disease.Methods A total of 68 patients with suspected coronary heart disease and non-emergency chest pain were examined by resting electrocardiogram and 256-slice spiral CTA.All patients were examined with CAG within 30 d.The diagnostic value of resting electrocardiogram,chest pain symptom and coronary artery CTA screening for coronary heart disease was analyzed by ROC curve based on CAG diagnosis.Results The area under the ROC curve of 256-slice spiral CTA in the diagnosis of coronary heart disease was 0.73(P<0.05).The diagnostic sensitivity was 96.55%,the specificity was 50.00%.The diagnostic value was greater than that of resting electrocardiogram(AUC=0.50,P>0.05) and chest pain(AUC=0.51,P>0.05).Conclusion 256-slice spiral CTA has a high diagnostic value for coronary heart disease,and resting electrocardiogram and chest pain symptoms have obvious limitations in the screening of coronary heart disease.