危险因素的评估在冠心病临床诊断中的参考价值研究

目的:探讨冠心病危险因素在诊断冠心病中的价值。方法:以选择性冠状动脉造影为金标准,对3355例临床诊断冠心病患者的主要冠心病危险因素(年龄、性别、糖尿病、高脂血症及高血压)和临床诊断符合率的关系进行分析。结果:3355例临床诊断冠心病的符合率为75.26%。无危险因素时冠心病临床诊断符合率仅为25%,有一个危险因素时为61.2%(P<0.001),冠心病危险因素越多,临床诊断符合率越高。患者年龄越大,符合率越高,误诊越少。男性、有糖尿病史、高脂血症患者符合率显著高于女性、无糖尿病、无高脂血症患者。尤其是≤50岁女性的临床诊断符合率仅为46.88%。高血压有无对诊断符合率无明显影响(P>0.05)。结论:冠心病整体危险因素评估对临床诊断冠心病有重要价值。应在了解冠心病整体危险因素基础上,评估临床表现和辅助检查结果,科学地作出冠心病诊断。

Role of independent risk factors in clinical diagnosis of coronary disease

Objective:To investigate the role of independent risk factors in clinical diagnosis of coronary artery disease(CAD).Method:A total of 3?355 consecutive patients suspected of CAD were studied respectively.All patients underwent selective coronary angiography and received a survey of risk factors,including age,gender,diabetes,hyperlipemia and hypertension.Then the relations between different risk factors and clinical diagnostic accuracies were identified.Result:Compared with the coronary angiographic findings,the clinically diagnostic accuracies in CAD patients with 0,1,2,3,4 and 5 risk factors were 25.00%,61.20%,75.66%,80.20%,85.34% and 93.02% respectively,while the general diagnostic accuracy was 75.26%.The clinically diagnosis was more accurate in aged patients,male,patients with diabetes or hyperlipemia than their respective counterpart(P<0.001).Hypertension had no significant impact on the diagnostic accuracy (P>0.05).Conclusion:The CAD risk factors is of great significance in the clinical diagnosis of CAD.