CAJ | 학술논문

目的：比较冠状动脉CT血管造影（CTA）与心电图对老年冠心病（CHD）患者的诊断价值。方法选择拟诊冠心病的老年住院患者148例，分别行冠状动脉CTA和心电图检查。其中有96例同时行冠状动脉造影检查。按冠状动脉造影结果分析冠状动脉CTA及心电图诊断冠心病的敏感度（阳性率）、特异度（阴性率）。结果冠状动脉CTA的敏感度为90.1%、特异度为88.1%、符合率为88.8%。心电图诊断CHD的敏感度为72.0%、特异度为57.1%、符合率为68.8%。冠状动脉造影狭窄程度≥90%的病变，心电图的敏感度最高，假阴性率最低；狭窄程度＜90%者与≥90%者比较，心电图敏感度较低，差异显著（均P＜0.01）。结论冠状动脉CTA发现有意义血管狭窄的敏感度、特异度较高，可作为老年冠心病诊断的有效方法；心电图对老年患者严重冠脉狭窄有一定的诊断价值。
목적：비교관상동맥CT혈관조영（CTA）여심전도대노년관심병（CHD）환자적진단개치。방법선택의진관심병적노년주원환자148례，분별행관상동맥CTA화심전도검사。기중유96례동시행관상동맥조영검사。안관상동맥조영결과분석관상동맥CTA급심전도진단관심병적민감도（양성솔）、특이도（음성솔）。결과관상동맥CTA적민감도위90.1%、특이도위88.1%、부합솔위88.8%。심전도진단CHD적민감도위72.0%、특이도위57.1%、부합솔위68.8%。관상동맥조영협착정도≥90%적병변，심전도적민감도최고，가음성솔최저；협착정도＜90%자여≥90%자비교，심전도민감도교저，차이현저（균P＜0.01）。결론관상동맥CTA발현유의의혈관협착적민감도、특이도교고，가작위노년관심병진단적유효방법；심전도대노년환자엄중관맥협착유일정적진단개치。
Objective To compare the value of computed tomographic coronary angiograpy (CTA) and electrocardiogram (ECG) in diagnosis of coronary artery disease (CAD) in elders. Methods 148 elders admitted for suspicious CAD were included and underwent CTA and ECG examination. Of them, 96 cases underwent coronary angiography. The sensitivity and specificity of CTA and ECG in diagnosis of CAD were determined based on the results of coronary angiography. Results The sensitivity, specificity and accuracy of CTA were 90.1%, 88.1% and 88.8%, respectively, those of ECG were 72%, 57.1%and 68.8%, respectively, in the diagnosis of CAD. The sensitivity of ECG was highest and false negative rate lowest in cases with vessel stenosis ≥90%. It was significantly lower in cases with stenosis <90% than in cases with stenosis≥ 90%(P<0.01). Conclusion Coronary CTA had higher sensitivity and specificity in detection of critical coronary stenosis and maybe used as an effective method in diagnosis of CAD in elders. ECG is of some value in diagnosis of serious coronary stenosis in elders.