耳折对不同年龄段冠心病患者预测价值临床相关性研究.docVIP

耳折对不同年龄段冠心病患者预测价值临床相关性研究 　　【摘要】目的 研究耳折与冠状动脉造影对不同年龄段患者冠心病诊断的一致性，探讨耳折对冠心病的预测价值。方法 选取2011年5月～2016年1月因胸痛等原因行冠状动脉造影的患者230例，根据冠脉造影结果分为冠心病组173例与对照组57例，其中59岁以下93例，60岁以上137例，男161例，女69例。目测法判断有无耳折。结果 耳折与冠脉造影对诊断冠心病具有正向一致性（Kappa=0.23，标准误0.07，p=0.00）。耳折判断低龄（60岁者）冠心病的敏感性为79.66%，特异性为47.06%，阳性预测值为72.31%，阴性预测值为57.14%，阳性似然比1.50，阴性似然比0.43。耳折判断女性冠心病的敏感性为89.36%，特异性为40.91%，阳性预测值为76.36%，阴性预测值为64.29%，阳性似然比1.51，阴性似然比0.26。结论 耳折与冠心病具有相关性，耳折对低龄女性患者冠心病的诊断价值更高。 　　【关键词】耳折；冠状动脉疾病；冠脉造影 　　【中图分类号】R541.4 【文献标识码】A 【文章编号】ISSN.2095-6681.2016.15.00.02 　　【Abstract】Objective To study the consistency of the diagnosis of coronary artery disease in different age groups with the ear break and coronary angiography， and to explore the predictive value of the ear fracture in the patients with coronary heart disease. Methods Selection of 2011 may to 2016 years 1 month for 230 patients underwent coronary angiography in chest pain and other reasons， according to coronary angiography were divided into CHD group 173 cases and control group （57 cases）， the age of 59 in 93 cases， 137 patients over 60 years old， male 161 cases， 69 cases of female. The visual method to determine whether the ear fold.Results Kappa test showed a positive consistence test in the ear lobe crease and coronarography for diagnosis of CHD（Kappa value 0.23，standard error 0.07， p=0.00）.The sensitivity of ear lob crease for the low age （under 60）CHD was 79.66%， specificity was 47.06%，positive predict value was 72.31%，negative predict value was 57.14%，positive likelihood ratio 1.50， negative likelihood ratio 0.43.The sensitivity of ear lob crease for the female CHD patients was 89.36%， specificity was 40.91%， positive predict value was 76.36%， negative predict value was 64.29%，positive likelihood ratio 1.51，negative likelihood ratio 0.26.Conclusion Ear lobe crease was associated with coronary heart disease，its predictive value was higher in the low age female CHD patients. 　　【Key words】Ear lobe crease；Coronary heart disease；Coronarography 　　随着医学