64层螺旋CT结合超敏C-反应蛋白对冠状动脉斑块性质的诊断价值  

Diagnostic Value of Combining 64-slice Spiral Computed Tomography with Serum High Sensitive C-reactive Protein on the Characteristic of Coronary Artery Plaques

作　　者：陈娟[1] 郭俊[1] 杨锴[1] 黎莉[1] 陈曼华[1] 

机构地区：[1]武汉市中心医院心血管内科,武汉430014

出　　处：《中国医学前沿杂志（电子版）》2012年第8期42-45,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨64层螺旋CT联合超敏C-反应蛋白(hs-CRP)对冠状动脉斑块性质判断的价值。方法纳入207例患者,入院后进行hs-CRP检测、64层螺旋CT检查、选择性冠状动脉造影术,对符合冠心病诊断标准的139例患者的资料进行分析:其中急性冠状动脉综合征(ACS)组56例,稳定型心绞痛(SAP)组83例,根据64层螺旋CT冠状动脉成像CT值将ACS组、SAP组罪犯血管处斑块分为软斑块、纤维斑块、钙化斑块;分析患者入院后hs-CRP浓度;根据冠状动脉造影结果,明确冠状动脉病变部位及程度。结果 SAP组与ACS组比较,两组在各项临床特征上无显著性差异;在SAP组,钙化斑块数量显著高于ACS组;在ACS组,软斑块及纤维斑块数量均显著高于SAP组,差异有显著性(χ2=63.394,P<0.001);不同程度冠状动脉狭窄组之间,不同性质的斑块分布差异无显著性;在64层CT检测到软斑块或纤维斑块,而临床分型为ACS组,患者的hs-CRP浓度最高(5.70±0.82 mg/ml),而在64层CT检测到钙化斑块,而临床分型为SAP组,hs-CRP浓度最低(0.38±0.05 mg/ml),差异均有显著性,P<0.05。结论联合hs-CRP水平检测,可提高64层螺旋CT对冠状动脉斑块性质判断的准确性,提高对对冠心病分型的准确性。Objective To evaluate the value of 64-slice spiral computed tomography combined with hsCRP on detect the characteristic of coronary artery plaques.Methods 207 cases of patients included in this investigation.After the hs-CRP test,64-slice spiral CT,selective coronary angiography,139 patients met the diagnostic criteria for coronary heart disease were analyzed:56 patients were acute coronary syndrome(ACS) group,83 patients were stable heart angina(SAP) group.Analysis of the 64-slice CT values of coronary artery plaques between two groups,then divided into soft plaque,fibrous plaque,calcified plaque groups;analysis of hs-CRP concentration.Results Compared between SAP group and ACS group,the clinical features has no significant difference;in the SAP group,the number of calcified plaques was significantly higher than the ACS group;in the ACS group,the number of soft plaques and fibrous plaques were significantly higher than the SAP group,the difference was statistically significant(χ 2 =63394,P<0001);various degrees of coronary stenosis among the different plaques had no statistical difference;the soft plaque or fibrous plaque patients in the ACS group,had the highest hs-CRP concentration(570 ± 082 mg/ml);and calcified plaque patients in SAP group,had the lowest hs-CRP concentration(038 ± 005 mg/ml),the differences were statistically significant,P<005.Conclusion Combined detection of hs-CRP levels can increase 64-slice spiral CT to determine the nature of the coronary artery plaque,improve the accuracy of classification of coronary heart disease.

关 键 词：冠状动脉粥样硬化性心脏病 体层摄影术 螺旋CT C反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]