64排CT冠状动脉成像对冠状动脉非闭塞病变介入指导作用的初步研究  

Preliminary study on value of 64 slice CT coronary angiography for coronary artery stenting in non-occluded coronary artery disease

作　　者：高迎春 张晓琴 武云涛[3] 杨署 胡晓辉 田志强 赵平 韩雅君 

机构地区：[1]内蒙古自治区人民医院心内科,内蒙古呼和浩特010020 [2]内蒙古自治区人民医院CT室,内蒙古呼和浩特010020 [3]北京军区总医院干一科,北京100700

出　　处：《临床荟萃》2012年第20期1749-1751,共3页Clinical Focus

基　　金：内蒙古自治区科技厅人口健康科技支撑项目(20080502)

摘　　要：目的探讨64排CT冠状动脉成像对冠状动脉非闭塞病变支架术的指导意义。方法连续入选接受64排CT冠状动脉成像同时冠状动脉造影显示为非闭塞病变的患者126例,所有患者经冠状动脉支架术治疗。根据支架释放后有无残余狭窄分为(A组、B组)两组,比较组间多排CT冠状动脉成像所示的斑块的性质、斑块的CT值、钙化长度、横断面最大钙化面积。结果斑块最大CT值有支架残余狭窄A组大于无支架残余狭窄B组(612.2±381.2)Hu vs(439.4±330.6)Hu(P<0.05)。多因素logistic回归分析显示,在校正了年龄、高血压、糖尿病、支架直径、支架释放压力、钙化面积与钙化长度后,斑块的最大CT值两组间差异仍具有统计学意义(OR=1.001,P<0.01)。支架释放后A组斑块的最大CT值较大。结论对于钙化不显著的冠状动脉非闭塞病变支架释放后出现残余狭窄与斑块的最大CT值有关,当斑块有明显大的CT值时,采用支架术需谨慎。Objective To explore the value of 64 slice CT coronary angiography for stenting in non-occluded coronary artery lesion. Methods 126 consecutive patients who had undergone 64 slice CT coronary angiography and coronary artery stenting were included in the study. The patients were divided into the underexpansion group and the non- underexpansion group according to the results after stent expansion. Lesion composition, CT value, length and maximal area of calcium were compared between the two groups. Results The maximal CT value was larger in the patients of the underexpansion group than that in the expansion group,（612. 2±381. 2） Hu vs （439.4±330.6） Hu（ P 〈0.05）. After adjustment for age, hypertension, diabetes mellitus, stent diameter, stent expansion atmosphere value, lesion calcium area and length, logistic analysis showed that the difference had statistic significance （ OR = 1. 001, P〈 0.01）. Conclusion This study suggests that the stent underexpansion relates to the maximal CT value of lesion,and it should be careful to implant stent to the lesion with overly large CT value.

关 键 词：冠状动脉疾病 体层摄影术 螺旋计算机 血管成形术 经腔 经皮冠状动脉 

分 类 号：R541.4[医药卫生—心血管疾病]