颈动脉超声联合动态心电图诊断老年冠心病的临床价值

目的探讨颈动脉超声联合动态心电图诊断老年冠心病(CHD)的临床价值。方法选取2019年1月至2020年1月于本院接受诊治的566例老年CHD患者作为观察组,并选取相同时期入院诊治的400例非CHD老年患者作为对照组。两组患者均给予动态心电图检查、颈动脉超声检查及CAG检查,观察不同诊断方式的应用效果。结果观察组单支、双支、三支病变患者的IMT增厚发生率及斑块发生率均高于对照组(P<0.05)。观察组的颈总动脉IMT、颈动脉分叉处IMT、颈动脉斑块等级积分及颈动脉斑块Crouse积分均高于对照组(P<0.05);观察组三支病变患者的颈总动脉IMT、颈动脉分叉处IMT、颈动脉斑块等级积分及颈动脉斑块Crouse积分均高于单支病变和双支病变,且双支病变高于单支病变(P<0.05)。颈动脉超声联合动态心电图检查诊断老年CHD的灵敏度均高于颈动脉超声、动态心电图单独检测(P<0.05)。结论颈动脉超声联合动态心电图诊断老年CHD的灵敏度更高,具有较高的临床价值。

Clinical value of carotid ultrasound combined with dynamic electrocardiogram in the diagnosis of coronary heart disease in the elderly

Objective To explore the clinical value of carotid ultrasound combined with dynamic electrocardiogram in the diagnosis of coronary heart disease(CHD)in the elderly.Methods A total of 566 elderly patients with CHD who received treatment in our hospital from January 2019 to January 2020 were selected as observation group,and 400 elderly patients without CHD admitted at the same period were selected as control group.The patients of the two groups were given dynamic electrocardiogram examination,carotid ultrasound examination and CAG examination,and the application effects of different diagnostic methods were observed.Results The incidences of IMT thickening and plaque of patients with single,double,three vessel lesions in the observation group were higher than those in the control group(P<0.05).The IMT of common carotid artery,IMT of carotid artery bifurcation,carotid plaque grade score and carotid plaque Crouse score in the observation group were higher than those in the control group(P<0.05);the IMT of common carotid artery,IMT of carotid artery bifurcation,carotid plaque grade score and carotid plaque Crouse score of patients with three vessel disease in the observation group were higher than those of the single vessel disease and double vessel disease,and those of the double vessel disease were higher than that of the single vessel disease(P<0.05).The sensitivity of carotid ultrasound combined with dynamic electrocardiogram in the diagnosis of CHD in the elderly were higher than that of carotid ultrasound and dynamic electrocardiogram alone(P<0.05).Conclusion Carotid ultrasound combined with dynamic electrocardiogram in the diagnosis of CHD in the elderly has higher sensitivity and higher clinical value.