CAJ | 학술논문

目的：评价冠状动脉造影金标准与临床诊断冠心病的可靠性。方法对临床诊断冠心病或可疑冠心病3355例患者行冠状动脉造影检查并常规诊断方法对比分析。结果总造影阳性率75．26％（2525／3355），其中心肌梗死组阳性率为93．85％（397／423），不稳定心绞痛组阳性率为79．88％（536／671），稳定心绞痛组阳性率为74．89％（1366／1824），可疑冠心病组阳性率为51．72％（226／437），临床诊断符合率心肌梗死组最高，与其他3组比较差异有统计学意义（P ＜0．05或 P ＜0．01）；其次为不稳定心绞痛组和稳定心绞痛组，与可疑冠心病组比较，差异有统计学意义（P ＜0．05）。结论冠心病和可疑冠心病临床误诊率较高，宜及时行选择性冠状动脉造影明确诊断。
목적：평개관상동맥조영금표준여림상진단관심병적가고성。방법대림상진단관심병혹가의관심병3355례환자행관상동맥조영검사병상규진단방법대비분석。결과총조영양성솔75．26％（2525／3355），기중심기경사조양성솔위93．85％（397／423），불은정심교통조양성솔위79．88％（536／671），은정심교통조양성솔위74．89％（1366／1824），가의관심병조양성솔위51．72％（226／437），림상진단부합솔심기경사조최고，여기타3조비교차이유통계학의의（P ＜0．05혹 P ＜0．01）；기차위불은정심교통조화은정심교통조，여가의관심병조비교，차이유통계학의의（P ＜0．05）。결론관심병화가의관심병림상오진솔교고，의급시행선택성관상동맥조영명학진단。
Objective To evaluate the reliability of conventional clinical diagnosis of coronary heart disease (CHD),as com-pared with the coronary angiography gold standards,and also to analyze reasons for CHD misdiagnosis.Methods A total of 3355 pa-tients clinically confirmed or suspected of CHD underwent coronary angiography,and the results obtained were compared with the clini-cal data.Results Generally,the positive rate of coronary angiography was 75.26%(2525 /3355).The clinically diagnostic accuracies in patients with myocardial infarction,unstable angina pectoris,stable angina pectoris and suspected CHD were 93.85%(397 /423), 79.88%(536 /671),74.89%(1366 /1824)and 51.72%(226 /437)respectively.With regard to the rate of diagnostic conformity,the patients with myocardial infarction ranked the first in diagnostic rate,and statistical significance could be seen,when comparisons were made with the other 3 groups(P <0.05 or P <0.01).Then came the patients with unstable angina pectoris and stable angina pectoris, and statistical significance could also be found,when compared with the patients with suspected CHD(P <0.05).Conclusion Coro-nary heart disease (CHD),especially suspected CHD,had relatively high rate of misdiagnosis clinically.For this reason,it was advis-able to perform coronary angiography and the said disease could be identified in time.