探讨冠状动脉CT血管成像(CCTA)联合动态心电图(DCG)在冠心病心肌缺血诊断中的应用价值。

选取286例疑似冠心病心肌缺血患者，所有患者均在入院2周内行核素心肌灌注显像(MPI)、CCTA、DCG检查。统计MPI、CCTA、DCG检查结果，并以MPI检查作为金标准，对比CCTA、DCG单一与联合诊断结果。

286例患者中，MPI共诊断出176例心肌缺血，CCTA检查共发现183例心肌缺血，DCG检查共发现152例心肌缺血。CCTA＋DCG联合诊断特异度与CCTA、DCG对比，差异无统计学意义(P>0.05)；CCTA＋DCG联合诊断敏感度、准确度高于CCTA及DCG(P<0.05)。

CCTA与DCG联合诊断冠心病心肌缺血敏感度和准确度较高，具有较高临床应用价值。

To observe the application value of coronary CT angiography (CCTA) combined with dynamic electro-cardiogram(DCG) in diagnosis of coronary heart disease combined with myocardial ischemia.

A total of 286 patients with suspected coronary heart disease combined with myocardial ischemia were selected. All patients were examined by radionuclide myocardial perfusion imaging (MPI), CCTA and DCG within 2 weeks of admission. The results of MPI, CCTA and DCG were counted, and the results of single and combined diagnosis of CCTA and DCG were compared according to the gold standard of MPI.

In 286 patients, 176 were diagnosed as myocardial ischemia by MPI, 183 by CCTA and 152 by DCG. The diagnostic specificity of CCTA + DCG combined with CCTA was not significantly different from that of CCTA and DCG (P>0.05). The diagnostic sensitivity and accuracy of CCTA combined with DCG were higher than those of CCTA or DCG (P<0.05).

CCTA combined with DCG has high sensitivity and accuracy in the diagnosis of coronary heart disease combined with myocardial ischemia, and has high clinical value.