CAJ | 학술논문

目的：研究多层螺旋CT（128-MSCTA）和冠状动脉造影（CAG）在冠心病诊断中的比较分析。方法对本院心血管科就诊的患者进行随机选择，选出符合条件的患者1640例，均进行128-MSCTA和CAG，得到3168处狭窄动脉节段，比较两法对狭窄程度的诊断情况，一致性以及128-MSCTA的诊断准确性。结果128-MSCTA诊断0级、1级、2级、3级和4级狭窄的例数为1152例、396例、564例、564例和492例；CAG分别为1164例、360例、516例、612例和516例，两种方法比较无统计学意义（P>0.05）。两组0级、1级、2级、3级和4级狭窄分别进行一致性比较，所得的Kappa值分别为0.96、0.87、0.89、0.87和0.94，两种方法的一致性较佳（Kappa>0.75）。128-MSCTA诊断冠心病敏感度最高的为诊断0级，97.91%；特异度最高的为1级，99.13%；阳性预测值最高的为0级，96.91%；阴性预测值最高为4级，99.55%。结论128-MSCTA诊断冠心病和判定冠脉狭窄程度效果同选择性CAG效果一致，作为创伤性小、安全的冠心病诊断方式，值得临床采用。
목적：연구다층라선CT（128-MSCTA）화관상동맥조영（CAG）재관심병진단중적비교분석。방법대본원심혈관과취진적환자진행수궤선택，선출부합조건적환자1640례，균진행128-MSCTA화CAG，득도3168처협착동맥절단，비교량법대협착정도적진단정황，일치성이급128-MSCTA적진단준학성。결과128-MSCTA진단0급、1급、2급、3급화4급협착적례수위1152례、396례、564례、564례화492례；CAG분별위1164례、360례、516례、612례화516례，량충방법비교무통계학의의（P>0.05）。량조0급、1급、2급、3급화4급협착분별진행일치성비교，소득적Kappa치분별위0.96、0.87、0.89、0.87화0.94，량충방법적일치성교가（Kappa>0.75）。128-MSCTA진단관심병민감도최고적위진단0급，97.91%；특이도최고적위1급，99.13%；양성예측치최고적위0급，96.91%；음성예측치최고위4급，99.55%。결론128-MSCTA진단관심병화판정관맥협착정도효과동선택성CAG효과일치，작위창상성소、안전적관심병진단방식，치득림상채용。
Objective Analyze the value of multi-slice spiral CT(128-MSCTA) and selective coronary arteriography (CAG)in the diagnosis of coronary heart disease. Methods Randomly selected 1640 patients who came to the cardiovascular department of our hospital and meet the conditions of the our study.The1640 patients all accepted both the multi-slice spiral CT and selective coronary angiography.Finally we got 3168 stenosis artery segment and compared the diagnosis of stenosis degree, consistency between 128-MSCTA and CAG and diagnosis accuracy of multi slice spiral CT.Results The number of 128-MSCTA diagnosis of 0 grade,1 grade, 2 grade, 3 grade and 4 grade stenosis were 1152 cases, 396 cases, 564 cases, 564 cases and 492 cases respectively; CAG were 1164 cases,360 cases, 516 cases, 612 cases and 516 cases.Comparison of the two methods had no statistical significance (P>0.05). Two methods diagnosed stenosis of 0 grade, 1 grade, 2 grade, 3grade and 4 grade respectively had consistency, the Kappa values were 0.96, 0.87, 0.89, 0.87 and 0.94, the consistency of two methods is good(Kappa>0.75).The highest sensitivity of Multi slice spiral CT in diagnosis of coronary heart disease was grade 0, 97.91%; the highest specificity is grade 1, 99.13%;the highest positive predictive value is grade 0, 96.91%; the highest negative predictive value is grade 4, 99.55%.Conclusion Multi slice spiral CT in diagnosis of coronary heart disease and in judgement of the degree of coronary artery stenosis have consistency with selective coronary arteriography . 128-MSCTA is a way of little trauma and safety, which is worthy of using.