64排螺旋CT联合ST-T改变对急性冠脉综合症斑块稳定性价值的研究  

The Diagnostic Value of Combining 64-slice Spiral Computed Tomography ECG ST-T Changes in The Plaque Stability of Acute Coronary Syndrome

作　　者：何伟喜[1,2] 杨芳[1,2] 卢静[1,2] 左明鲜[1,2] 章体玲[1,2] 光雪峰[1,2] 

机构地区：[1]昆明医学院附属延安医院心内科 [2]云南心血管病医院,云南昆明650051

出　　处：《昆明医学院学报》2010年第8期45-48,共4页Journal of Kunming Medical College

摘　　要：目的本研究通过64层螺旋CT联合心电图ST-T段动态改变检查,从临床角度探讨其对急性冠脉综合征(ACS)患者易损斑块的临床价值.方法入选2008年10月至2010年4月昆明市延安医心血管内科住院治疗的,接受冠脉造影、64排螺旋CT冠脉造影检查和心电图检查的141例患者,并对其冠状动脉斑块性质进行评价.入选本研究的患者根据临床诊断分为三组:正常对照组25例、稳定型心绞痛组(SAP)32例、急性冠脉综合征组(ACS)(不包括急性ST段抬高的心肌梗死)84例.据64排螺旋CT检查根据斑块性质分为四组:正常对照组、钙化斑块组、混合斑块组、软斑块组.结果在ACS组软斑块、混合斑块的分布比SAP组显著高,而硬斑块的分布显著低于ACS组,差异有统计学意义(P<0.01);ACS组ST-T动态改变发生率显著高于SAP和对照组(P<0.01),而SAP和对照组无差异(P>0.05);软斑块组、混合斑块组ST-T动态改变发生率显著高于对照组和硬化斑块组,差异有统计学意义(P<0.01),而软斑块组和混合斑块组两组ST-T改变发生率,差异无统计学意义(P>0.05);冠心病患者斑块稳定性与ST-T动态改变发生呈负相关.结论 64排螺旋CT联合心电图ST-T动态改变检查,可对冠状动脉斑块性质判别的准确性进行评估,从而提高对急性冠脉综合征的诊断率。Objective To explore diagnostic value of combining 64-slice spiral computed tomography with ECG ST-T changes in the plaque stability of coronary artery syndrome.Methods 141 patients who received coronary angiography tests,64-slice spiral computed tomography and ECG examination were enrolled form October 2008 to April 2010 in this hospital.The plaque stability of coronary artery of patients was evaluated.According to the clinical diagnose,patients were divided into three groups：25 cases in normal group,32 cases in stable angina pectories group（SAP） and 84 cases in acute coronary syndrome group（ACS）（excepted ST-segment elevation myocardial infarction）.According to 64-slice spiral computed tomography tests,they were divided into four group：normol group,soft plaque group,mix plaque group and hard plaque group.Results The cases of soft plaque and mix plaque were significantly more than hard plaque in ACS group,and the cases of hard plaque in SAP group were significantly more than that in ACS group（P〈0.01）.The incidence of changes in ST-T in ACS group were higher than that in SAP group and normal group（P 0.01）.The incidence of changes in ST-T in SAP group and normal group had no obvious statistical difference（P〈0.05）.The incidence of changes in ST-T in soft plaque group and mix plaque group were higher than that in hard plaque group and normal group（P〈0.01）.The incidence of changes in ST-T in soft plaque group and mix plaque group had no obvious statistical difference（P〈0.05）.The quality of plaque in CHD patients was correlated negatively to the changes of ST-T.Conclusion The combining 64-slice spiral computed tomography with ST-T changes can accurately assess the stability of coronary artery plaque in patients with ACS,and improve the diagnosis rate.

关 键 词：64排螺旋CT ST-T 急性冠脉综合征 斑块 稳定性 

分 类 号：R543.31[医药卫生—心血管疾病]