双源CT对PCI术后冠状动脉支架通畅性及左心室功能的评价  

Assessment of dual-source CT on stent patency and left ventricular function after PCI in coronary heart disease

作　　者：周裔忠[1,2] 杨明[1,2] 张繁之[1,2] 盛国太[1,2] 祝善俊[3] 

机构地区：[1]江西省心血管病研究所 [2]江西省人民医院心内1科,南昌330006 [3]第三军医大学新桥医院,重庆400030

出　　处：《重庆医学》2014年第17期2121-2123,共3页Chongqing medicine

基　　金：江西省卫生厅课题资助项目(20091004)

摘　　要：目的：观察双源CT（DSCT）在评价冠心病患者经皮冠状动脉介入治疗（PCI）术后支架通畅性及左心室功能中的应用。方法2010年1月至2011年12月入选的90例患者，共植入支架162枚，于PCI术后12个月分别行冠状动脉造影及 DSCT检查（二者相隔5～7 d）。利用DSCT分析冠状动脉支架狭窄情况，应用左心室功能分析软件分别测定和计算左心室的射血分数、每搏输出量、收缩末容积、舒张末容积等参数。同时利用超声心动图测量上述指标。结果90例患者中，冠状动脉造影显示6例患者出现再狭窄（6．7％），DSCT显示7例患者出现再狭窄（7．7％）。相比冠状动脉造影，DSCT的敏感性为83．3％，特异性为97．6％，准确性为96．7％，阳性预测值71．4％，阴性预测值98．8％。冠状动脉造影结果显示共有11枚支架出现再狭窄，双源 CT能检测出10枚支架出现再狭窄，支架再狭窄检出率二者分别为6．8％、6．2％，差异无统计学意义（P＞0．05）。相比冠状动脉造影，DSCT敏感性为72．7％，特异性为98．7％，准确性为96．9％，阳性预测值80．0％，阴性预测值98．0％。舒张末容积、收缩末容积、每搏输出量、左心室射血分数在心脏超声和DSCT之间存在较好的相关性（P＜0．05）。结论双源 CT可用于 PCI术后支架通畅性及左心室功能的评价。Objective To investigate the evaluation of the stents patency and the left ventricular function after coronary artery stents implantation by dual-source computed tomography （DSCT）coronary angiography.Methods 90 patients with PCI（162 im-plantation stents）from January 2010 to December 2011 in our hospital were selected and performed the coronary angiography and DSCT examination（5-7 d apart）in 1 2 months after PCI operation.Meanwhile,DSCT was adopted to analyze the coronary stent stenosis and the left function anaaysis software was used to detect and calculate the left ventricular function related indexes：EDV, ESV,SV,LVEF.Results Among 90 cases,the coronary angiography displayed 6 cases of stent restenosis（6.7%）,DSCT displayed 7 cases of stent restenosis（7.7%）.Compared with the coronary angiography,the sensitivity,specificity,accuracy,positive prediction value and negative prediction value in DSCT were 83.3%,97.6%,96.7%,71.4% and 98.8% respectively.Among 162 stents,the coronary angiography displayed 11 stents with restenosis（6.8%）and DSCT displaye 10 stents with restenosis（6.2%,P〈0.05）. Compared with the coronary angiography,the sensitivity,specificity,accuracy,positive prediction value and negative prediction value in DSCT were 72.7%,98.7%,96.9%,80.0% and 98.0%.The results of EDV,ESV,SV and LVEF showed better correlation be-tween cardiac ultrsonography and DSCT（P〈0.05）.Conclusion DSCT can be used to evaluate the stent patency and the left ven-tricular function after PCI.

关 键 词：双源计算机断层成像系统 经皮冠状动脉介入治疗 支架通畅性 左心室功能 

分 类 号：R541.4[医药卫生—心血管疾病]