超声心动图诊断冠心病临床应用分析.docVIP

超声心动图诊断冠心病临床应用分析 　　[摘要] 目的 讨论超声心动图（ultrasonic cardiography，UCG）在冠心病诊断方面的临床应用价值。 方法 回顾性分析679例拟诊为冠心病的患者，所有病例均行UCG及冠状动脉造影（coronary angiography，CAG）检查。UCG利用左室16节段划分法多切面观察各室壁运动情况，以CAG结果为金标准，讨论节段性室壁运动异常与冠脉病变的关系。 结果 UCG诊断冠心病的敏感性、特异性、准确性、阳性预测值及阴性预测值分别为34.9%、95.0%、38.4%、99.1%及8.4%。其中心绞痛组和心肌梗死组的敏感性分别为7.7%和74.6%，心肌梗死组的敏感性明显高于心绞痛组，差异有统计学意义（P0.01）。冠脉病变分为单支、双支、三支病变，UCG诊断冠心病的敏感性随着病变血管支数的增加而增加，差异有统计学意义（P0.01）。UCG诊断冠心病的敏感性随着病变血管狭窄程度的加重而增加，差异有统计学意义（P0.01）。 结论 UCG作为无创性检查，在诊断冠心病方面具有重要的临床意义，但因其敏感性及准确性不高，故在临床应用中需综合分析判断。 　　[关键词] 超声心动图；冠状动脉造影；冠心病；室壁运动异常 　　[中图分类号] R445.1 [文献标识码] B [文章编号] 1673-9701（2017）28-0098-04 　　[Abstract] Objective To discuss the clinical application value of ultrasonic cardiography（UCG） in the diagnosis of coronary heart disease. Methods A total of 679 patients with coronary heart disease were retrospectively analyzed. UCG and coronary angiography（CAG） were performed in all cases. Ventricle wall movement was observed from multi-section by UCG via left ventricular 16-segment division method. CAG results were used as gold standard， and the relationship between segmental wall motion abnormality and coronary artery lesion was discussed. Results The sensitivity， specificity， accuracy， positive predictive value and negative predictive value of coronary heart disease by UCG were 34.9%， 95.0%， 38.4%， 99.1% and 8.4% respectively. The sensitivity of the angina pectoris group and the myocardial infarction group were 7.7% and 74.6%， respectively（P0.01）. The sensitivity of the myocardial infarction group was significantly higher than that of the angina pectoris group， and the difference was statistically significant（P0.01）. Coronary lesions were divided into single， double， three lesions. The sensitivity of UCG in the diagnosis of coronary heart disease increased with the increase of the number of vascular lesions， and the difference was statistically significant（P0.01）. The sensitivity of coronary heart disease（CHD） increased with the severity of coronary artery stenosis， and