| 冀舒文,王 英,黄金昭,李 辉,陈先国.冠状动脉CTA和DSA对冠心病患者的临床诊断价值比较[J].,2020,(16):3109-3112 |
| 冠状动脉CTA和DSA对冠心病患者的临床诊断价值比较 |
| Clinical Diagnostic Value of CTA and DSA in Patients with Coronary Heart Disease |
| 投稿时间：2020-02-03 修订日期：2020-02-27 |
| DOI：10.13241/j.cnki.pmb.2020.16.023 |
| 中文关键词: 冠状动脉 CT血管成像 数字减影血管造影 冠心病 诊断价值 |
| 英文关键词: Coronary artery CT angiography(CTA) Digital subtraction angiography(DSA) Coronary heart disease Diagnostic value |
| 基金项目:国家自然科学基金项目（81470986）；安徽医科大学校科学研究基金项目（2019xkj152） |
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| 中文摘要: |
| 摘要 目的：比较冠状动脉CT血管成像(CT angiography，CTA)以及数字减影血管造影(digital subtraction angiography，DSA)诊断冠心病的临床价值差异。方法：选择2013年12月至2020年3月安徽医科大学第三附属医院、安徽医科大学第四附属医院收治的60例冠心病患者为研究对象，首先对其实施多排螺旋CT冠状动脉血管造影检测(CTA)，而后2 w内再对其实施DSA检测，比较两种检测方式对不同血管狭窄程度、不同性质斑块检出率的差异，最后以DSA检测结果为金标准，评估CTA对冠状动脉狭窄诊断的一致性、灵敏度、特异度、阳性预测值和阴性预测值。结果：(1)CTA检测狭窄血管共计387支，轻度狭窄152支(39.28 %)，中度狭窄118支(30.49 %)，重度狭窄105支(27.13 %)，闭塞12支(3.10 %)；DSA检测狭窄血管392支，轻度狭窄150支(38.27 %)，中度狭窄124支(31.63 %)，重度狭窄112支(28.57 %)，闭塞6支(1.53 %)，两组各血管狭窄类型比较差异无统计学意义(P>0.05)；(2)CTA检测斑块69个，其中钙化斑43个(62.32 %)，非钙化斑26个(37.68 %)，DSA检测斑块61个，其中钙化斑33个(54.10 %)，非钙化斑28个(45.50 %)，两种检测方式差异无统计学意义(P>0.05)；(3)以DSA检测为金标准，CTA对重度及以上血管狭窄诊断一致性为99.23 %，特异度为98.31 %，灵敏度为99.64 %，阳性预测值为99.15 %，阴性预测值为99.27 %。结论：与DSA相比，CTA对冠心病患者血管狭窄的诊断价值相当，且属于无创检测，在冠心病早期筛查中临床应用价值更高。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the clinical value of coronary artery CT angiography (CTA) and digital subtraction angiography (DSA) in the diagnosis of coronary heart disease (CHD). Methods: Sixty CHD patients who were treated in the Third Affiliated Hospital of Anhui Medical University and the Fourth Affiliated Hospital of Anhui Medical University from December 2013 to March 2020 were selected as the research subjects. Firstly, CTA was performed on them, and then DSA was performed within 2 weeks. The detection rates of different stenosis and plaques of different properties by the two detection methods were compared. The DSA was used as the gold standard to evaluate the consistency, sensitivity, specificity, positive predictive value and negative predictive value of CTA in the diagnosis of coronary artery stenosis. Results: There were 387 stenosis vessels detected by CTA, 152 mild stenosis vessels (39.28 %), 118 moderate stenosis vessels (30.49 %), 105 severe stenosis vessels (27.13 %), and 12 occlusion vessels (3.10 %). 392 stenosis vessels detected by DSA, 150 mild stenosis vessels (38.27 %), 124 moderate stenosis vessels (31.63 %), 112 severe stenosis vessels (28.57 %), and 6 occlusion vessels (1.53 %). There was no significant difference in the types of vascular stenosis between the two groups (P>0.05). There were 69 plaques detected by CTA, including 43 calcified plaques (62.32 %), 26 non calcified plaques (37.68 %), 61 detected by DSA, including 33 calcified plaques (54.10 %), 28 non calcified plaques (45.50 %), and the difference between the two detection methods was not statistically significant (P>0.05). Taking the DSA test as the gold standard, the diagnostic consistency of CTA of severe and above vascular stenosis was 99.23 %, specificity was 98.31 %, sensitivity was 99.64 %, positive predictive value was 99.15 %, and negative predictive value was 99.27 %. Conclusion: Compared with DSA, the CTA was equivalent to the diagnosis of coronary artery disease, and it is a non-invasive test, with high accuracy and sensitivity. The clinical application value is higher in the early screening of coronary heart disease. |
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