多层螺旋CT时代冠状动脉造影人群不同治疗方案选择比例  

Different therapeutic proportion of the patients undergoing coronary angiography in the era of development in multislice spiral computed tomography

作　　者：梁峰[1] 胡大一[2] 吴明英[3] 李田昌[3] 汤楚中[2] 王吉云[3] 卢长林[3] 

机构地区：[1]首都医科大学大兴医院心内科,北京102600 [2]北京大学人民医院心脏中心 [3]首都医科大学附属北京同仁医院心脏中心

出　　处：《山西医科大学学报》2011年第8期650-652,共3页Journal of Shanxi Medical University

基　　金：北京市卫生系统高层次卫生技术人才培养项目资助(2009-3-68);首都医学发展科研基金(2009-3261)

摘　　要：目的报道多层螺旋CT时代冠状动脉造影人群比例。方法选自2007-02～2009-07于首都医科大学大兴医院行冠状动脉造影的连续1 027例患者,其中男性642例,女性385例,平均年龄(58.31±10.01)岁。根据冠状动脉造影结果,冠状动脉狭窄<50%者不诊断冠心病,任何一支狭窄≥50%者诊断冠心病;病变狭窄≥70%,而病变及临床情况适合支架植入者,方可置入支架;冠状动脉旁路移植手术的建议依据指南推荐。结果 1 027例患者行冠状动脉造影结果显示,183例(17.82%)患者正常;844例(82.18%)患者诊断冠心病,其中273例(26.58%)不需支架置入(包括支架置入后随访性冠状动脉造影),315例(30.67%)置入支架,218例(21.23%)建议行冠状动脉旁路移植术,38例(3.7%)行支架置入未成功或适合介入治疗但因其他原因未进行治疗者。结论多层螺旋CT有助于避免诊断性冠状动脉造影,提高造影患者的阳性率。Objective To evaluate the different therapeutic proportion of the patients undergoing coronary angiography（CAG）in the era of development in multislice spiral computed tomography（MSCT）.Methods A total of 1 027 consecutive patients,who underwent CAG in Daxing Hospital from February 2007 to July 2009,were enrolled,642 males and 385 females.The patients were not diagnosed to have coronary heart disease（CHD） with less than 50% diameter stenosis of coronary artery by coronary angiogram,but the patients to have CHD with more than or equal to 50% stenosis of coronary artery.The patients with more than or equal to 70% stenosis could be performed the percutaneous coronary intervention（PCI）,and the decision-making for PCI is mainly based on the clinical demonstration and the coronary lesion morphology,which was suitable for PCI.The patients were proposed to have coronary aortic bypass graft（CABG） surgery based on the guideline.Results Of 1 027 consecutive patients,183 patients（17.82%）had not been diagnosed to have CHD,and 844（82.18%）to have CHD.Of these patients with CHD,273 patients（26.58%）were not indicated for PCI（including the patients receiving follow-up coronary angiography after stenting）,315（30.67%）had been performed the stent implantation,218（21.23%）were proposed to have CABG,38（3.7%）failed in the procedure of PCI or had not been performed because of opposing to this therapy.Conclusion MSCT can be applied as a non-invasive screening tool to avoid coronary angiography for the diagnosis of CHD,and to increase the positive proportion of the patients with CHD after receiving coronary angiograhpy.

关 键 词：冠心病 多层螺旋CT 冠状动脉造影 

分 类 号：R540.4[医药卫生—心血管疾病]