冠状动脉钙化检测联合动态心电图对冠心病的诊断价值及临床应用

目的探讨冠状动脉钙化检测联合动态心电图对冠心病的诊断价值及临床应用。方法对2010年5月-2011年8月住院的108例拟诊冠心病的患者同期进行128排螺旋CT冠状动脉钙化积分检测、动态心电图和冠状动脉造影,对比研究冠状动脉钙化检测联合动态心电图预测冠心病的价值。结果冠状动脉钙化阳性预测冠心病的灵敏度、特异度、阳性预测值和阴性预测值分别为75.6%、81.0%、73.9%、82.3%;动态心电图阳性预测冠心病的灵敏度、特异度、阳性预测值和阴性预测值分别为73.3%、76.2%、68.8%、80.0%;冠状动脉钙化检测联合动态心电图的系列实验的特异度和阳性预测值分别达到96.8%和92.9%,平行试验的灵敏度和阴性预测值分别达到93.3%和92.7%,均显著高于单项试验的相应指标(P<0.05)。结论高分辨率螺旋CT冠状动脉钙化检测联合动态心电图显著提高冠心病的诊断价值,可作为老年患者及基层医院冠心病首选的筛选检查。

Diagnostic Value and Clinical Application of the Combination of Coronary Artery Calcification and Holter for Coronary Artery Disease

Objective To investigate the diagnostic value and clinical application of the combination of coronary artery calcification(CAC) and Holter for coronary artery disease(CHD).Methods From May 2010 to August 2011,we performed 128-slice spiral computed tomography,Holter and coronary angiography simultaneously on 108 suspected CHD patients.The value of CAC and Holter in diagnosing CHD was separately and unitedly evaluated.Results The sensitivity,specificity,positive and negative predictive value of CAC positive in diagnosing CHD were 75.6%,81.0%,73.9%,and 82.3%,respectively.The corresponding parameters of Holter positive were 73.3%,76.2%,68.8%,and 80.0%.After combining CAC and Holter,the specificity and positive predictive value of serial test were 96.8% and 92.9%,and the sensitivity and negative predictive value of parallel test were 93.3% and 92.7%,which respectively surpassed the corresponding parameters of single examination(P<0.05).Conclusions Coronary artery calcification detected by high resolution spiral computed tomography associated with Holter can significantly enhance their diagnostic value for coronary artery disease.They can be used as the preferred screening examination for gerontal patients with coronary artery disease in primary hospitals.