摘要
目的分析动态心电图联合冠脉CT血管造影(CTA)对冠心病心肌缺血的诊断价值。方法选取2023年5月至2025年5月我院收治的100例疑似冠心病心肌缺血患者作为研究对象,均接受动态心电图与冠脉CTA检查,以冠状动脉造影(CAG)检查结果作为诊断“金标准”,分析动态心电图、冠脉CTA单一与联合检查对冠心病心肌缺血的诊断效能;将金标准下阳性患者按照冠脉狭窄程度分为Ⅰ~Ⅱ级组、Ⅲ~Ⅳ级组,对比两组的动态心电图参数(ST段变化幅度与持续时间)、CTA参数[血流储备分数(FFR)、最小管腔面积(MLA)]。结果CAG检查结果证实,冠心病心肌缺血阳性58例、阴性42例。动态心电图联合冠脉CTA诊断冠心病心肌缺血的准确性、灵敏度、特异度分别为96.00%、96.55%、95.24%,均较二者单一检查高(P<0.05);冠脉狭窄程度Ⅰ~Ⅱ级组35例(60.34%)、Ⅲ~Ⅳ级组23例(39.66%);与Ⅰ~Ⅱ级组患者比较,Ⅲ~Ⅳ级组患者的ST段改变幅度明显更大,持续时间明显更长,FFR、MLA明显更低(P<0.05)。结论动态心电图、冠脉CTA对冠心病心肌缺血均有一定诊断价值,而二者联合诊断效能更高;动态心电图参数与CTA参数相结合,可为临床评估冠心病患者的冠脉狭窄程度提供重要依据。
Objective To analyze the diagnostic value of dynamic electrocardiogram combined with coronary CT angiography(CTA)for myocardial ischemia due to coronary heart disease.Methods A total of 100 patients with suspected myocardial ischemia due to coronary heart disease from May 2023 to May 2025 were selected as the research subjects.All of them underwent dynamic electrocardiogram and coronary CTA examinations.Taking the results of coronary angiography(CAG)as the diagnostic"gold standard",the diagnostic efficacy of single and combined examinations of dynamic electrocardiogram and coronary CTA for myocardial ischemia due to coronary heart disease was analyzed.The positive patients under the gold standard were divided into gradeⅠ~Ⅱgroup and gradeⅢ~Ⅳgroup according to the degree of coronary artery stenosis.The dynamic electrocardiogram parameters(ST segment change amplitude and duration)and CTA parameters[fractional flow reserve(FFR),minimum lumen area(MLA)]of the two groups were compared.Results The CAG examination results confirmed 58 positive cases and 42 negative cases of myocardial ischemia due to coronary heart disease.The accuracy,sensitivity,and specificity of dynamic electrocardiogram combined with coronary CTA in diagnosing myocardial ischemia due to coronary heart disease were 96.00%,96.55%,and 95.24%,respectively,higher than those of either method alone(P<0.05).There were 35 cases(60.34%)in the gradeⅠ~Ⅱgroup of coronary artery stenosis and 23 cases(39.66%)in the gradeⅢ~Ⅳgroup.Compared with patients of gradeⅠ~Ⅱgroup,gradeⅢ~Ⅳgroup exhibited significantly greater ST-segment alteration amplitude,longer duration,and lower FFR and MLA(P<0.05).Conclusions Both dynamic electrocardiogram and coronary CTA have certain diagnostic value for myocardial ischemia due to coronary heart disease,but their combined use demonstrates higher diagnostic efficacy.The combination of dynamic electrocardiogram parameters and CTA parameters can provide an important basis for clinically assessing the degree of coronarystenosis in patients with coronary heart disease.
作者
林福根
胡永辉
LIN Fugen;HU Yonghui(Xiamen Third Hospital,Xiamen 361100,China)
出处
《临床医学工程》
2025年第12期1383-1386,共4页
Clinical Medicine & Engineering
关键词
动态心电图
冠状动脉CT血管造影
冠心病
心肌缺血
诊断价值
Dynamic electrocardiogram
Coronary CT angiography
Coronary heart disease
Myocardial ischemia
Diagnostic value
