320排CT血管造影筛查老年消化道出血并冠心病的应用价值

摘要

Objective To assess the diagnostic value for gastrointestinal hemorrhage senile patients with potential coronary artery disease using 320-row coronary angiography with CT (CTA). Methods A total of 71 gastrointestinal bleeding senile patients without coronary heart disease (CHD) history were successively accepted conventional 12-director electrocardiogram (ECG) and 320-row CTA in two weeks from being admitted to hospital. Among those patients, 26 accepted the X-ray coronary angiography (CAG) examination in six weeks. The diagnostic values of each method were compared in diagnosing gastrointestinal hemorrhage patients with potential coronary artery disease. Results In all 71 patients, 29 (40.84%) who positive coronary heart disease (CHD) test results were obtained using 320-row CTA and only 19 ( 26. 76% ) were gotten using ECG. There was statistical significance between the two methods ( P < 0.05). In 26 patients which were studied by using CAG examination, 16 (61. 53% ) who positive coronary heart disease test results were obtained using 320-row CTA and only 15 (57. 69% ) were gotten using CAG examination. There was no statistical significance in diagnostic positive rate for CHD through the two methods (P > 0.05 ) . For diagnosing CHD, CTA gained an accuracy of 96.15% ( sensitivity 100% and specificity 90. 91 % ). Conclusions Coronary 320-row CTA angiography can be used as one of the preferred method in diagnosing gastrointestinal hemorrhage senile patients with potential coronary artery disease.%目的 探讨心脏320排CT血管造影(CTA)筛查老年消化道出血并冠心病(CHD)的临床价值.方法 选择71例无CHD病史的老年消化道出血患者,入院后2周内依次行常规12导联心电图(ECG)、心脏320排CTA检查,其中26例入院6周内行冠脉造影(CAG)检查；比较各种方法筛查CHD的临床价值.结果 71例患者中,CTA检查示CHD阳性29例(40.84％),ECG检查示CHD阳性19例(26 76％),CTA检查诊断CHD的阳性率明显高于ECG(P ＜0.05).行CAG检查的26例患者中,CAG检查示CHD阳性15例(57.69％),CTA检查示CHD阳性16例(61 53％),两种方法诊断CHD的阳性率无统计学差异(P＞0.05)；CTA检查诊断CHD的灵敏度为100％,特异度为90.91％,阳性预测值为93.75％,阴性预测值为100％.结论 心脏320排CTA可作为无创筛查老年消化道出血患者是否合并CHD的首选方法之一.