摘要
目的探讨冠状动脉CT血管造影(CTA)、血清同型半胱氨酸(Hcy)和胱抑素C水平对无症状冠心病的诊断价值。方法选取110例疑似无症状冠心病患者作为研究对象,以冠状动脉造影检查为诊断金标准,采用受试者工作特征(ROC)曲线分析血清Hcy、胱抑素C水平单独及联合冠状动脉CTA诊断无症状冠心病的价值。结果110例疑似患者中,共有89例被诊断为无症状冠心病,21例为非冠心病患者。无症状冠心病患者血清Hcy水平高于非冠心病患者,而胱抑素C水平低于非冠心病患者(均P<0.05)。冠状动脉CTA诊断无症状冠心病的灵敏度、特异度、准确度、阳性预测值和阴性预测值分别为95.51%、90.48%、94.55%、97.70%和82.61%。血清Hcy、胱抑素C水平诊断无症状冠心病的ROC曲线下面积分别为0.798和0.873,最佳截断值分别为9.80μmol/L和1.30 mg/L,灵敏度分别为70.50%和96.80%,特异度分别为82.00%和75.50%;冠状动脉CTA联合血清Hcy、胱抑素C水平诊断无症状冠心病的ROC曲线下面积为0.960,灵敏度和特异度分别为84.00%和92.00%。结论冠状动脉CTA、血清Hcy和胱抑素C水平对无症状冠心病均有较好的诊断价值,三者联合应用时可进一步提高诊断效能,值得临床参考。
Objective To investigate the value of coronary CT angiography(CTA),serum homocysteine(Hcy)level and cystatin C level on the diagnosis of asymptomatic coronary heart disease.Methods A total of 110 patients with suspected asymptomatic coronary heart disease were selected as the research subjects.Coronary arteriography was taken as the golden standard,and the value of serum Hcy and cystatin C levels alone and combined with coronary CTA for diagnosing asymptomatic coronary heart disease was analyzed by the receiver operating characteristic(ROC)curve.Results Among 110 suspected patients,a total of 89 cases were diagnosed as asymptomatic coronary heart disease,and 21 cases as non-coronary heart disease.Serum Hcy level of patients with asymptomatic coronary heart disease was higher than that of patients without coronary heart disease,whereas cystatin C level was lower than that of patients without coronary heart disease(all P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of coronary CTA for diagnosing asymptomatic coronary heart disease were 95.51%,90.48%,94.55%,97.70%,and 82.61%,respectively.The areas under the ROC curve of serum Hcy and cystatin C levels for diagnosing asymptomatic coronary heart disease were 0.798 and 0.873,respectively,and the optimal cut-off values were 9.80μmol/L and 1.30 mg/L,respectively,as well as the sensitivities were 70.50%and 96.80%,respectively,the specificities were 82.00%and 75.50%,respectively;in addition,the area under the ROC curve of coronary CTA combined with serum Hcy and cystatin C levels for diagnosing asymptomatic coronary heart disease was 0.960,and the sensitivity and specificity were 84.00%and 92.00%,respectively.Conclusion Coronary CTA,serum Hcy and cystatin C levels exerts a relatively favourable diagnostic value on asymptomatic coronary heart disease,employing the combination of the three can further improve diagnostic efficiency,which is worth of clinical reference.
作者
张玉强
王金宝
李鑫
李晓军
杨笑一
魏立杰
张代辉
陈洪波
刘莎
李星亮
ZHANG Yuqiang;WANG Jinbao;LI Xin;LI Xiaojun;YANG Xiaoyi;WEI Lijie;ZHANG Daihui;CHEN Hongbo;LIU Sha;LI Xingliang(Department of CT/Nuclear Magnetic,Xingtai Third Hospital,Xingtai 054000,Hebei,China;Department of Reproductive Medicine,Xingtai Third Hospital,Xingtai 054000,Hebei,China;Department of Cardiology,Xingtai Third Hospital,Xingtai 054000,Hebei,China)
出处
《广西医学》
CAS
2023年第1期30-33,共4页
Guangxi Medical Journal
基金
河北省邢台市科技计划自筹经费项目(2019ZC240)。
