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|本期目录/Table of Contents|

三种无创性检查方法诊断冠心病的评价(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
1997年第1期
页码:
1-4
栏目:
论著
出版日期:
1997-01-01

文章信息/Info

Title:
Evaluation on non-invasive methods for diagnosing coronary heart disease
作者:
李兰荪1　黄久仪2　贾国良1　李良寿2　区晋禧1　陈士良1　何　耀2　石丘玲2
四军医大学　1 西京医院心脏内科　2 流行病学教研室　西安 710032
Author(s):
Li Lansun1;  Huang Jiuyi2;  Jia Guoliang1; Li Liangshou2; Ou Jinxi1;  Chen Shiliang1;  He Yao2 and Shi Qiulin2
1Department of Cardiology,Xijing Hospital 2Department of Epidemiology,Fourth Military Medical University , Xi′an 710032
关键词:
冠状动脉疾病　心血管造影术　超声心动描记术　断层摄影术　心电描记术
Keywords:
coronary heart disease　　angiocardiography　　electrocardiography　　echocardiography 　　tomography
分类号:
-
DOI:
-
文献标识码:
-
摘要:
作者以冠状动脉造影(CAG) 检查为金标准, 127例病人以冠心病收入院, 行CAG检查, 并行心电图(ECG)、心脏B超和心肌灌注断层显像等无创伤检查, 对其诊断效能进行评价。结果显示: ECG, 心脏B超和心肌灌注断层显像的敏感度分别为60.3%、70.9%和90.5% ,特异度分别为54.7%、62.3%和21,4%;准确度分别为57.5%、66.7%和62.9%。ECG 和心脏B 超联合试验可使敏感度提高到78.2% , 特异度提高到83.0%。心肌灌注显像的特异度较低, 但对CA G 不能检出冠状动脉的微血管病变而心肌灌注显像对此类病人的敏感度却较高。心脏B超检出的舒张期功能障碍特别是同时合并节段性室壁运动异常对冠心病的诊断具有重要意义。
Abstract:
The coronary arteriography (CAG) as a golden diagnostic standard was performed in 127 patients with high probability of coronary heart disease (CHD) in our hospital.As non-invasive examinations, electrocardiography (ECG),echocardiography and 99mTc-MIBI myocardial perfusiongraphy were compared with the golden standard in diagnosis of CHD.The results showed that the sensitivities of ECG, echocardiography and myocardial perfusiongraphy were 60.3% ,70.9% and 90.5%. Their specificities were 54.7% ,62.3%and 21.4%.The accuracies were 57.5%. 66.7% and 62.9%,respectively. Combining ECG with echocardiography the sensitivity could be raised to 78.2% and the specificity to 83%.Nucleo-myocardial perfusiongraphy had lower specificity, while higher sensitivity in cases of micro2-vessel damage, which couldn′t be shown by CAG.It is very important for diagnosis of CHD that the diastolic dysfunction, especially associated with segmented left ventricular wall motion disorders found by echocardiography.

参考文献/References

［1］Bemard RC, Martial GB, Pierre W , et al. Improved efficiency of treadmill exercise testing using a multiple lead ECG system and basic hemodynamic exercise response. Circulation,1978; 57: 71.

［2］Kanl S, Kiess M , Deter L , et al. Comparison of exercise electrocardiography and Thallium imaging for-one vessel coronary artery disease.Am J Cardiol, 1985; 56: 275.

［3］钱蕴秋, 李　军, 赵树杰, 等. 冠心病患者二维超声心动图与冠状动脉造影对照研究. 中华心血管病杂志, 1991; 19 (6) : 345.

［4］Massmo MA,Paolo M , Alessandro S, et al.Exercise echocardiography and Technetium-99m MIBI single-phototon emission computed topography in detection of coronary artery disease.Am J Cardiol, 1991; 67: 350.

［5］George AD. How accurate in SPEC Thallium scintigraphy? JACC, 1990; 16 (4) : 1017.

［6］刘秀杰,寇 文,姚宝康,等.核素心肌灌注显像对冠心病诊断的特异性评价.中华核医学杂志,1992;12 (3):135.

［7］高润林, 陈在嘉, 徐义枢, 等. X 综合征—附六例报告. 中华心血管病杂志, 1992; 20 (5) : 292.

备注/Memo

备注/Memo:
Received 1996-01-02；revised 1996-06-21
更新日期/Last Update: 1997-01-01