应用256层CT冠脉成像评价冠脉斑块的稳定性  

Clinical Study on Evaluation of Coronary Plaques Stability by combining 256-Slice Computed Tomography

作　　者：黄炫生[1,2] 张励庭[1,2] 刘卫其[1,2] 李芳云[1,2] 刘辉来[1,2] 吴惠玉[1,2] 

机构地区：[1]广东省中山大学附属中山医院 [2]广东省中山市人民医院

出　　处：《中西医结合心脑血管病杂志》2012年第11期1291-1293,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨256层CT冠脉成像(CTA)评判冠脉斑块稳定性的可行性及临床应用价值。方法入选不稳定型心绞痛(UAP)患者40例及稳定型心绞痛(SAP)组患者40例,分别依次完成256层CT冠脉及冠脉造影(CAG),对比分析"罪犯"血管内"罪犯"斑块处的CT值及CAG的表现。结果以临床诊断以及CAG影像表现为标准,判断不稳定型心绞痛患者及稳定心绞痛病人的"罪犯"血管及"罪犯"斑块,其检出率为100%,均能完成CT值的测量及CAG测量。CT测量病变狭窄程度:UAP组"罪犯"斑块处血管狭窄率为(77.17±12.86)%,SAP组"罪犯"斑块处血管狭窄率为(82.30±6.16)%。病变的狭窄程度两组间无统计学意义(P>0.05)。"罪犯"病变斑块的CT值方面:UAP组"罪犯"斑块CT值为(78.70±36.79)Hu,SAP组"罪犯"斑块CT值为(180.63±86.14)Hu。UAP组"罪犯"病变斑块的CT值较低,两组间有统计学意义(P<0.01)。结论 256层CT冠脉成像可以作为一种无创性检查手段,对检出冠脉斑块有较高的敏感性,而且能较准确地对斑块密度做出定量的诊断,间接反映CHD患者病变冠状动脉斑块的性质及稳定性。Objective To study the clinical value of 256 - slice computed tomography on evaluating the stability of coronary plaques. Methods Eighty patients were enrolled and divided into two groups according to their clinical situation： Unstable angina group （UAP,n= 40） and stable angina group （SAP,n = 40）. All patients underwent 256 -slice computed tomography angiography （CTA） and coronary angiography, （CAG） in sequence. The CT value of ＂culprit＂ plaque and the CAG images of ＂culprit＂ lesions in their ＂culprit＂ vessels were relatively analyzed. And another 40 healthy people whose 256 - slice computed tomography angiography （CTA） images were detected normal were selected as the control group. Results Taking clinical diagnosis and CAG as standard, the detectable rate of patients＇ culprit vessel and culprit plaque suffered from unstable angina and stable angina is 100%, which fulfils the biochemical test. Stenosis rate of the vessel in which ＂culprit＂ plaque located in UAP group is （77.17±12.86）%. While it is （82.30±6, 16）% in SAP group. There was no statistical difference between the two groups（P=0. 054）. CT value of ＂culprit＂ plaque in UAP group is 78.70 Hu±36.79 Hu while in SAP group it is 180.63 Hu±86, 14 Hu. It is statistically lower in UAP group（P〈0.01）. Conclusion 256 - slice computed tomography coronary angiography should be recommend as a reliable,noninvasive diagnosis method for coronary disease census in high risk population and screening for high risk coronary disease. Not only it had higher sensibility in detecting coronary plaques but also it could evaluate the character and stability by correctly measuring the density of the plaques.

关 键 词：256层CT 体层摄影术 冠状动脉 斑块稳定性 

分 类 号：R541.4[医药卫生—心血管疾病] R256.2[医药卫生—内科学]