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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。
Objective To investigate the diagnostic value and clinical application of coronary artery calcification combined with ambulatory electrocardiogram in patients with coronary heart disease. Methods One hundred and eighty patients diagnosed with CHD who were hospitalized from May 2010 to August 2011 were enrolled in this study. 128-slice spiral CT coronary angiogram, dynamic electrocardiogram and coronary angiography were performed in the same period. Coronary artery calcification combined with ambulatory electrocardiogram The value of coronary heart disease. Results The sensitivity, specificity, positive predictive value and negative predictive value of coronary artery calcification in patients with coronary heart disease were 75.6%, 81.0%, 73.9% and 82.3%, respectively. The sensitivity, specificity and positive predictive value And negative predictive values were 73.3%, 76.2%, 68.8% and 80.0% respectively. The specificity and positive predictive value of series of coronary artery calcification combined with ambulatory electrocardiography were 96.8% and 92.9% respectively. The sensitivity and negative predictive value of parallel test Values were 93.3% and 92.7%, respectively, which were significantly higher than the corresponding indicators of single test (P <0.05). Conclusion High-resolution spiral CT coronary artery calcification combined with Holter monitoring significantly improve the diagnostic value of coronary heart disease, coronary heart disease can be used as elderly patients and primary screening screening.