摘要
目的:探讨冠状动脉CT血管造影(冠脉CTA)检查判断冠脉管腔狭窄程度受斑块性质的影响,为临床正确判断冠心病提供可靠依据。方法:回顾性分析2017年1月-2019年1月航空总医院收治的103例冠心病患者的临床资料,以冠状动脉造影(CAG)为冠脉管腔狭窄评估金标准,分析CTA在冠脉管腔狭窄评估中应用价值,并分析CAG冠脉管腔狭窄与斑块病变的评估结果。结果:103例冠心病患者中,冠脉CTA共检出冠状动脉狭窄245节段,轻度狭窄组、中度狭窄组、重度狭窄和闭塞组各95、81、69节段,各占38.78%(95/245)、33.06%(81/245)和28.16%(69/245)。冠脉第6段(前降支近段)与其他段相比狭窄程度占比最高(54.69%)。在冠脉CTA检出的245处狭窄节段中,CAG共检测出钙化斑块90个、混合斑块89个、低密度斑块66个,检出率分别为36.73%(90/245)、36.33%(89/245)、26.94%(66/245)。冠脉CTA检出低密度斑块的准确率高于混合斑块和钙化斑块,而混合斑块检出准确率则高于钙化斑块(P<0.05)。结论:冠脉CTA可对冠心病冠脉管腔狭窄具体情况进行有效评估,并观察出冠脉管腔狭窄程度与斑块病变,在诊断冠脉管腔狭窄程度时结合斑块性质来判断会更为准确。
Objective:To evaluate the influence of the plaque properties on the evalution of the coronary artery stenosis by CT angiography(CTA),which can provide reliable evidence for clinical judgement of coronary heart disease.Method:The clinical data of 103 patients with coronary heart disease admitted to Aviation General Hospital from January 2017 to January 2019 were retrospectively analyzed.The application value of CTA in the assessment of coronary artery stenosis was analyzed using CAG as the gold standard for the assessment of coronary artery stenosis,and the assessment results of CAG coronary artery stenosis and plaque lesions was analyzed.Result:In 103 coronary heart disease patients,coronary CTA detected 245 segments of coronary artery stenosis,which accounted for 38.78%(95/245),33.06%(81/245)and 28.16%(69/245)in the mild,moderate,severe stenosis and occlusioned groups,respectively.Compared with other coronary artery segments,stenosis degree occurred in the sixth segment(proximal anterior descending branch)with the highest proportion(54.69%).Among 245 stenosis segments detected by CTA,90 calcified plaques,89 mixed plaques and 66 low-density plaques were detected by CAG,with detection rates of 36.73%(90/245),36.33%(89/245)and 26.94%(66/245),respectively.The accuracy of coronary CTA in detecting low-density plaques was significantly higher than that of mixed plaques and calcified plaques,while that of mixed plaques was higher than that of calcified plaques(P<0.05).Conclusion:Coronary CTA can assess coronary artery stenosis for coronary heart disease and detect the degree of stenosis and plaque lesion.It will be more accurate if we take plaque properties into consideration when evaluating the degree of coronary artery stenosis.
作者
申太忠
谢灵争
李宝
王淑荔
杨欢
SHEN Taizhong;XIE Lingzheng;LI Bao;WANG Shuli;YANG Huan(不详;Aviation General Hospital,Beijing 100012,China)
出处
《中外医学研究》
2022年第7期71-74,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
CT血管造影
冠心病
冠脉管腔狭窄
斑块性质
CT angiography
Coronary heart disease
Coronary artery stenosis
Plaque properties
