摘要
目的：观察双源CT（DSCT）评价急性心肌梗死患者急诊PCI术后支架通畅性和左心室功能。方法2010年1月至2011年12月入选的急性心肌梗死且行急诊PCI患者46例，共植入火鸟第二代支架52枚，支架直径在3.0～4.0 mm范围内，于急诊PCI后第12月末分别行冠状动脉造影及DSCT检查（两者相隔5～7 d）。利用DSCT分析冠状动脉支架是否存在再狭窄，应用左心室功能分析软件测定和计算左心室功能相关指标：舒张末期容积（EDV），收缩末期容积（ESV），每搏输出量（SV），左心室射血分数（LVEF）。同时利用超声心动图测量上述指标。结果（1）46例患者中，冠状动脉造影显示共有3例患者出现支架再狭窄，此3例患者中有2例被DSCT正确判断；共有43例患者支架无狭窄，此43例患者中有41例被DSCT正确判断。和冠状动脉造影相比，DSCT 的敏感性为66.67%，特异性为95.34%，准确性为93.47%，阳性预测值为50%，阴性预测值为97.6%。（2）在52枚支架中，冠状动脉造影显示共有5枚支架出现再狭窄，此5枚支架有3枚被DSCT正确判断，共有47枚支架无再狭窄，此47枚支架有44枚被DSCT正确判断。相比冠状动脉造影，DSCT的敏感性为60%，DSCT的特异性为93.61%，DSCT的准确性为90.38%，阳性预测值为50%，阴性预测值为95.65%。（3）超声心动图和DSCT测定的EDV、ESV、SV、LVEF无统计学差异。结论双源CT能评价用于急性心肌梗死患者急诊PCI支架通畅性和左心室功能。
Objective To appraise the stents patency and left ventricular function in patients received Emergency PCI due to acute myocardial infarction by dual-source computed tomography （DSCT） coronary angiography.Methods 46 patients with acute myocardial infarction were underwent coronary angiography and DSCT coronary angiography 12 months after emergency PCI between January 2010 and December 2011 in our hospital. Meanwhile, the EDV, ESV, SV（SV=EDV-ESV）, LVEF[（EDV-ESV）/EDV] were observed by DSCT and Ultrasonic Cardiogram （UCG） in all patients.Results （1） In 46 patients, coronary angiography showed stent restenosis in 3 patients , but 2 patients were judged correctly by DSCT in the 3 patients. Compared with coronary angiography, the sensitivity, the specificity, the accuracy, the positive predictive value, the negative predictive value of the DSCT were 66.67%, 95.34%, 93.47%, 50%, 97.6%, respectively. （2）In 52 stents, coronary angiography showed 5 stents were restenosis, but only 3 stents were judged correctly by DSCT in the 5 stents. Compared with coronary angiography, the sensitivity, the specificity, the accuracy, the positive predictive value, the negative predictive value of DSCT were 60%, 93.61%, 90.38%, 50%, 95.65%, respectively. （3）EDV, ESV, SV, LVEF were significant correlated between echocardiography and DSCT.Conclusion DSCT can appraise the patency and left ventricular function in patient emergency PCI by acute myocardial infarction.
出处
《中华临床医师杂志（电子版）》
CAS
2013年第21期77-79,共3页
Chinese Journal of Clinicians(Electronic Edition)
关键词
心肌梗死
血管成形术
经腔
经皮冠状动脉
双源CT
支架通畅性
Myocardial infarction
Angioplasty, transluminal, percutaneous coronary
Dual-sourcecomputed tomography
Stent patency
