摘要
目的探讨冠状动脉CT成像显示为轻度狭窄（狭窄程度25％～50％）的急性胸痛低危患者的短期预后以明确其是否需要进一步行诊断性检查。方法纳入2008年3月。2012年2月邯郸市中心医院心肌梗死溶栓（TIMI）危险评分为低危、冠状动脉CT成像显示为轻度狭窄的急性胸痛患者215例。通过观察患者30天内的主要不良心血管事件（心肌梗死、不稳定心绞痛、冠状动脉血运重建和心血管死亡），以明确行进一步诊断检查的必要性。结果30d随访期间，仅1例患者（0．5％）发生了主要不良心血管事件（95％CI：0％～2．6％），该患者在住院期间第3次复查肌钙蛋白T时呈阳性结果。无患者发生心血管死亡或需要血运重建。结论冠状动脉CT成像显示为轻度狭窄的急性胸痛患者近期发生主要不良心血管事件的可能性非常低，对此类患者行系列心脏生物学标志物检查有可能获益，但无需行进一步诊断检查。
Objective To investigate the short-term prognosis of mild coronary stenosis （25%-50%） diagnosed by coronary computerized tomography （CT） in the patients with acute chest pain, and determine if they need further diagnostic examinations. Methods The patients （n=215） with lower risk TIMI scores and mild coronary stenosis diagnosed by coronary CT were chosen from Handan Central Hospital from Mar. 2008 to Feb. 2012. The necessity of further diagnostic examinations was determined through observing the incidence of major adverse cardiovascular events （MACE） within 30 days including myocardial infarction, unstable angina, coronary revascularization and.cardiovascular death. Results During 30-dya follow-up period, there was only one patients （0.5%） with MACE （95%CI： 0%-2.6%）, who had positive resuhs of cardiac troponin T reexamined for three times during hospitalization. No patients experienced cardiovascular death or required coronary revascularization. Conclusion The possibility of short-term onset of MACE is very low in the patients with mild coronary stenosis diagnosed by coronary CT. Although the examination of serial biomarkers will be beneficial for these patients, further diagnostic tests are not necessary.
出处
《中国循证心血管医学杂志》
2013年第5期483-484,共2页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
急性冠脉综合征
冠状动脉CT成像
胸痛
预后
Acute coronary syndrome
Coronary computerized tomography
Chest pain
Prognosis
