付伟 刘吉昌 闫继栋

[摘要] 目的 探讨CT冠脉造影和数字减影血管造影（DSA）在急性冠脉综合征的临床诊断中应用。 方法 随机选取聊城市复退军人医院2016年1月～2017年10月接收的急性冠脉综合征患者28例为研究对象，所有患者均给予CT冠脉造影和DSA检查，并对两种方法的诊断精准率进行比较。 结果 CT冠脉造影检查结果示，急性冠状综合征26例，真阳性率为92.86%，真阴性率为100%，诊断敏感性为100%，特异性为89.29%；DSA检查结果示，急性冠状综合征24例，真阳性率为78.57%，真阴性率为100%，敏感性为100%，特异性为82.14%。两种检测方法的敏感度及真阴性率比较，差异无统计学意义（P > 0.05）；CT冠脉造影的阳性率和特异性均高于DSA检查，差异有统计学意义（P < 0.05）。此外，CT冠脉造影检查斑块的数量要低于DSA，其中钙化斑块和非钙化斑块的检出率与DSA检出率差异无统计学意义（P > 0.05）。 结论 在急性冠脉综合征患者进行诊断的过程中，CT冠脉造影检查操作简便，而且具有较高的准确度，在临床诊断中可以广泛应用，进而为患者的治疗提供更有力的保障。

[关键词] CT冠脉造影；数字减影血管造影；急性冠脉综合征；诊断精准率

[中图分类号] R816；R541 [文献标识码] A [文章编号] 1673-7210（2018）09（a）-0137-04

[Abstract] Objective To study the application of CT coronary angiography and digital subtraction angiography （DSA） in the clinical diagnosis of acute coronary syndrome. Methods Twenty-eight patients with acute coronary syndrome admitted in Veterans Hospital of Liaocheng City from January 2016 to October 2017 were selected as subjects. All the patients were given CT coronary angiography and DSA examination， and the diagnostic precision of two methods were compared. Results CT coronary angiography results showed that there were 26 cases of acute coronary syndrome， the true positive rate was 92.86%， the true negative rate was 100%， the diagnostic sensitivity was 100%， and the specificity was 89.29%. DSA results showed that there were 24 cases with acute coronary syndrome， true positive rate was 78.57%， the true negative rate was 100%， the diagnostic sensitivity was 100%， and the specificity was 82.14%. The sensitivity and true negative rate of the two detection methods had no statistically significant difference （P > 0.05）. The positive rate and specificity of CT coronary angiography were higher than those of DSA， and the difference was statistically significant （P < 0.05）. In addition， the number of plaques examined by CT coronary angiography was less than DSA. There was no significant deifference of calcified plaque and non calcified plaque detection rate by CT coronary angiography or DSA （P > 0.05）. Conclusion In the diagnosis process acute coronary syndrome， CT coronary angiography method is easy to handle and and it has high accuracy， that can be used widely in clinic， so as to provide more effective protection for patients.

[Key words] CT coronary angiography； Digital subtraction angiography； Acute coronary syndrome； Diagnostic accuracy

在人們生活物质条件不断改善的同时，社会节奏也变得越来越快，与此同时，冠心病患者的人数也呈逐年上升的趋势，在中老年人群中，冠心病已经成为了对其生命安全构成威胁的一项严重影响因素。一直以来，在诊断冠心病的方法中，DSA的应用最为广泛，并被称为“金标准”，不过该方法在检查中具有一定的创伤性，至今致死率已经高达2/10 000，并发症发生率为1.33%[1]，而且患者需要承担比较高的费用，对其家庭经济状况造成了不利影响，而且在中小医院中也很难得到普及。在……