| 赵雪梅,李家俊,刘亚欣,张宇.多层螺旋CT血管造影在评价冠状动脉粥样硬化性心脏病患者心肌缺血程度中的价值[J].中国临床保健杂志,2017,20(6):693-695. |
| 多层螺旋CT血管造影在评价冠状动脉粥样硬化性心脏病患者心肌缺血程度中的价值 |
| The Value of multislice CT angiography in evaluating the degree of myocardial ischemia in patients with coronary atherosclerotic heart disease |
| 投稿时间：2017-08-01 |
| DOI：10.3969/J.issn.1672-6790.2017.06.019 |
| 中文关键词: 冠状动脉疾病 心肌缺血 静脉造影术 体层摄影术,螺旋计算机 |
| 英文关键词: Coronary artery disease Myocardial ischemia Phlebography Tomography, spiral computed 〖FL |
| 基金项目:高等学校博士学科点专项科研基金(20131106120009) |
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| 中文摘要: |
| 目的 研究多层螺旋CT血管造影(MSCTA)在评价冠状动脉粥样硬化性心脏病(CAD)患者心肌缺血程度中的作用。方法 选取初诊疑为冠心病的患者102例,分别采用MSCTA以及冠脉血管造影(CAG)检查,并以CAG诊断结果为“金标准”,分析MSCTA诊断冠脉狭窄的敏感度、特异度、阳性预测值、阴性预测值以及准确度。同时,根据CAG结果将冠状动脉狭窄分为轻度狭窄、中度狭窄以及重度狭窄。此外,对所有患者进行核素心肌灌注显像检查,并计算CAG和MSCTA共同确诊的182支狭窄冠脉所匹配的心肌异常灌注区静息、负荷总积分以及灌注积分差。结果 以CAG诊断为“金标准”,102例患者MSCTA结果显示87例患者213支冠状动脉狭窄,诊断狭窄敏感性、特异性、阳性预测值、阴性预测值和准确度分别为97.17%,94.85%,96.71%,95.56%和96.26%；MSCTA诊断冠状动脉轻度狭窄率、中度狭窄率以及重度狭窄率分别为23.94%(51/213)、21.60%(46/213)、54.46%(116/213),与CAG22.53%(48/213)、19.25%(41/213)、54.93%(117/213)相比,均差异无统计学意义(均P＞0.05)。轻度狭窄冠状动脉所匹配的心肌异常灌注区负荷总积分和灌注积分差低于中度狭窄以及重度狭窄,而中度狭窄冠状动脉所匹配的心肌异常灌注区心肌负荷总积分和灌注积分差又低于重度狭窄,均差异有统计学意义(均P＜0.05)。经Spearman相关性分析,冠状动脉狭窄程度与心肌血流异常灌注区负荷总积分和灌注积分差呈显著正相关关系(r=0.758和r=0.636,均P＜0.001)。结论 MSCTA可有效评价CAD患者的心肌缺血程度。 |
| 英文摘要: |
| Objective To study the value of multislice angiography(MSCTA) in evaluating the degree of myocardial ischemia in patients with coronary atherosclerotic heart disease.Methods A total of 102 patients suspected coronary atherosclerotic heart disease(CAD)with newly diagnosed were selected,underwent both MSCTA and coronary angiography(CAG).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of MSCTA in diagnosis of coronary stenosis were assessed with CAG as its golden standard.At the same time,according to the result of the CAG,coronary artery stenosis can be divided into mild stenosis,moderate stenosis and severe stenosis.In addition,all patients underwent myocardial perfusion imaging(MPI)with SPECT.A total of 182 narrow coronary arteries confirmed by CAG and MSCTA and correponding myocardial perfusion abnormal areas were found and calculated summed rest score(SRS),summed stress score(SSS),summed difference score(SDS).Results MSCTA showed stenosis in 213 coronary arteries of 87 patients.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 97.17%,94.85%,96.71%,95.56%,96.26% respectively with CAG as its golden standard.MSCTA showed rates of mild stenosis,moderate stenosis and severe stenosis in coronary artery stenosis were 23.94%(51/213),21.60%(46/213),54.46%(116/213)respectively,compared with the CAG 22.53%(48/213),19.25%(41/213),54.93%(117/213),no significant difference was found(P＞0.05).SSS and SDS of myocardial perfusion abnormal areas with mild stenosis coronary arteries were lower than moderate stenosis and severe stenosis,SSS and SDS of myocardial perfusion abnormal areas with moderate stenosis coronary arteries were lower than severe stenosis,significant differences was found(all P＜0.05).By the Spearman rank correlation analysis,significant positive correlation between coronary artery stenosis degree and SSS,SDS of myocardial perfusion abnormal areas(r=0.758 and r=0.636,P＜0.001).Conclusion MSCTA can effectively evaluate the degree of myocardial ischemia in patients with CAD. |
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