冠心病患者64层螺旋CT冠状动脉成像斑块成分与狭窄程度的相关性研究  

Study of Correlation Between Coronary Plaque Composition and Degree of Stenosis by 64-slice Spiral Computed Tomography Coronary Angiography in Patients with Coronary Heart Disease.

作　　者：周懂晶[1] 邵福全[1] 刘玉品[1] 江勋源[1] 曾秋华[1] 

机构地区：[1]广东省中医院影像科,广州510120

出　　处：《医学研究杂志》2010年第2期64-67,共4页Journal of Medical Research

摘　　要：目的应用64层螺旋CT冠状动脉成像检查方法,探讨冠心病患者冠状动脉斑块成分与狭窄程度之间的相关性,为预测冠心病风险、早期识别易损患者提供诊断依据。方法回顾性分析广东省中医院101例临床拟诊冠心病或冠心病患者的64层螺旋CT冠状动脉成像检查的结果,冠状动脉影像表现由2位心血管CT诊断医师独立判断冠状动脉斑块成分及测量冠状动脉狭窄程度,结果一致时诊断为冠心病。采用SPSS 13.0统计分析软件,应用卡方检验和对应分析,探讨冠状动脉斑块成分与狭窄程度之间的相关性。结果在101例患者中,冠状动脉无狭窄30例(30/101,29.7%),轻度狭窄29例(29/101,28.7%),中度狭窄18例(18/101,17.8%),重度狭窄24例(24/101,23.8%)。本组71例冠状动脉不同程度狭窄的患者中,斑块成分中以软斑块(53/71,74.6%)最多见。冠状动脉斑块成分与狭窄程度之间比较具有统计学意义(P<0.05),提示冠状动脉斑块成分与狭窄程度关系密切。两者之间做对应分析,提示软斑块与重度狭窄、混合性斑块与中度狭窄之间具有密切相关性。结论 64层螺旋CT冠状动脉成像能够有效检测冠心病患者冠状动脉斑块的成分及准确判断冠状动脉狭窄程度。利用64层螺旋CT冠状动脉成像对斑块成分评价,可以预测冠心病风险,早期识别易损患者。Objective To explore the correlation between the coronary plaque composition and the degree of stenosis by 64 - slice CT coronary angiography,which can provide the diagnosis evidence for predicting the risk of coronary heart disease and the early identification of vulnerable patients. Methods The data of coronary angiography of 101 patients with suspected or documented coronary artery disease on 64 - slice spiral CT in Guangdong Province Hospital of Traditional Chinese Medicine were analyzed retrospectively. The images were interpreted by 2 doctors. When there was consistency, coronary heart disease was obtained by the diagnosis of coronary plaque composition and the degree of coronary artery stenosis. SPSS13.0 statistical analysis software was used to analyze the relationship of coronary plaque composition and the degree of stenosis by chi - square test and correspondence analysis. Results In the 101 patients, as to the degree,30 cases of coronary artery without stenosis （30/101,29.7%）, while mild coronary stenosis accounts for 29 cases（29/101,28. 7 % ）, moderate for 18 （18/101,17.8 % ）, severe for 24 （24/101,23.8 % ）. The relationship between degree of stenosis and plaque composition was analyzed in 71 patients. Soft plaque prevailed in 53 cases（53/71,74.6% ）. There was statistical significance, indicating that the degree of coronary artery stenosis was closely related to plaque composition. Soft plaque was related to severe degree stenosis, while mixed plaque to moderate degree. Conclusion 64 - slice CT coronary angiography can effectively detect coronary plaque composition and the degree of coronary artery stenosis. 64 - slice CT coronary angiography can be employed to evaluate plaque composition of coronary artery,so predict the risk of CHD. Earlier detection of vulnerable patients can be presumed.

关 键 词：冠心病 64层螺旋CT 冠状动脉斑块成分 冠状动脉狭窄程度 

分 类 号：R445[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]