冠状动脉造影投照体位与患者体型及心型关系的定量分析(英文)  

Correlation of optimal angiographic viewing angles to body and heart types:A quantitative analysis

作　　者：吴延庆[1] 许美珍[1] 李頣 程晓曙[1] 柴俊兵[1] 

机构地区：[1]南昌大学第二附属医院心内科,江西省南昌市330006

出　　处：《中国组织工程研究与临床康复》2008年第4期779-782,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:冠脉动脉造影被称为诊断冠心病的"金标准",但由于投照体位的不当,造成病变血管段人为"缩短"及冠状动脉显影影像质量较差等均可引起误诊或漏诊。目的:探讨不同体型、心型患者的冠状动脉主干及各分支的最佳投照体位的特异性关系。设计:对照观察。单位:南昌大学第二附属医院心内科。对象:2001-11/2006在南昌大学第二附属医院行行冠状动脉造影术患者1369例。所有受试者均签署了冠状动脉造影书面知情同意书,实验方案得到了南昌大学医学院医学伦理委员会的批准。方法:将1369例患者分为3组:①肥胖组:体质量指数26～31kg/m2,489例,横位心。②普通体型组:体质量指数23～25kg/m2,502例,普通心型。③消瘦组:体质量指数17～22kg/m2,378例,垂位心型。对3组受试者的左冠状动脉主干,前降支近段,前降支中远段、回旋支近段、回旋支中远段、右冠状动脉近中段,远段等血管的Compart分析结果进行归纳。主要观察指标:最佳造影角度。结果:1369例均进入结果分析。①冠状动脉主干最佳造影角度:左前斜位(45±5)°/足位(25±5)°或右前斜位25°/足位35°,肥胖者其角度大10°左右,消瘦者小10°左右(P均﹤0.05)。②前降支近段最佳造影角度:右前斜位(50±8)°/头位(23±8)°,肥胖者其角度大10°左右,消瘦者其角度小10°左右(P均﹤0.05)。③前降支中远段最佳造影角度:右前斜位(40±5)°/头位(45±5)°或左前斜位(11±5)°/头位(45±5)°。④回旋支近段最佳造影角度:左前斜位(45±5)°/足位(35±5)°或AP/足位36°。⑤回旋支中远端最佳造影角度:左前斜位(45±5)°/足位(35±5)°或右前斜位(6±4)°+足位(33±5)°。⑥右冠状动脉近中段最佳造影角度:左前斜位(35±5)°/足位(14±5)°或左前斜位(48±5)°/头位(15±5)°,肥胖、消瘦组左前斜位角度都要大15°左右,右前斜位胖者角度小10°左右,瘦者角度大10°左右(P<0.05)。⑦右�BACKGROUND：Coronary angiography is called ＂the golden standard＂ for the diagnosis of coronary heart disease （CAD）. Foreshortening of vessel segments in angiographic projection images usually caused by the inappropriate projection angles or positions may lead to misdiagnosis or missed diagnosis. OBJECTIVE： To investigate the optimal angiographic views of main coronary artery and its branches in different somatotype or heart type patients and to investigate the specific relationships between the optimal angiographic views and the different somatotypes and heart types with computer-assisted techniques. DESIGN： A controlled observation. SETTING： Department of Cardiology, the Second Affiliated Hospital of Nanchang University. PARTICIPANTS： Altogether 1 369 patients were admitted to the Second Affiliated Hospital of Nanchang University to undergo coronary angiography from January 2001 to December 2006 and recruited for this study. Written informed consents of coronary angiography were obtained from all the patients. The protocol was approved by the Medical Ethics Committee of Medical College of Nanchang University. METHODS： All 1 369 inpatients were assigned into 3 groups by body mass index （BMI）： fat somatotype group （n =489, BMI： 26-31 kg/m^2, transverse heart type）, general somatotype group （n =502, BMI： 23-25 kg/m^2, general heart type）, and thin somatotype group （n =378, BMI： 17-22 kg/m^2 vertical heart type）. In each group, all arteries including left main coronary artery （LM）, proximal segment of the anterior descending coronary artery （LAD）, distal-mid segment of LAD, proximal segment of circumflex branch （LCX）, distal-mid segment of LCX, proximal-mid and distal segments of right coronary artery （RCA） were properly and carefully analyzed using Compart software, and then we got its optimal angiographic viewing angle. Finally, we arranged these data and induced whether different somatotype group patients have different optimal angiographic viewing

关 键 词：冠状动脉造影 最佳投照体位 不同体型 心型 

分 类 号：R318[医药卫生—生物医学工程]