应用128层CT评价右冠状动脉重度狭窄的左室功能  

Assessment of the Influence of Right Coronary Artery Severe Stenosis on Left Ventricular Function with 128 Slice Computed Tomography Coronary Angiography

作　　者：程英[1] 蔡新琦[2] 孙俊旗[1] 庞军刚[3] 方先来[1] 卢雨零[1] 张红平[1] 

机构地区：[1]粤北人民医院影像诊断科,广东韶关512026 [2]粤北人民医院急诊科,广东韶关512026 [3]粤北人民医院心血管内科,广东韶关512026

出　　处：《CT理论与应用研究（中英文）》2016年第1期65-70,共6页Computerized Tomography Theory and Applications

基　　金：韶关市科技计划项目(2013CX/K05)

摘　　要：目的：了解右侧冠状动脉严重狭窄对左心室整体及局部功能的影响。方法：从128层螺旋CT冠状动脉检查的患者中,选择右侧冠状动脉狭窄程度大于75%并经冠脉造影证实的34人为病变组;选择无冠状动脉病变的22人为对照组。将心动周期间隔10%,分割成0%~90%10个相位,自动测量左室收缩末期容积（ESV）和舒张末期容积（EDV）及射血分数（EF）,重建左室收缩末期及舒张末期短轴位,分别测量左室下壁、下间壁收缩末期厚度（ESWT）和舒张末期厚度（EDWT）,分别计算、比较和分析左室下壁和下间壁的收缩期增厚率（SWT）。结果：病变组ESV较对照组增高,两组ESV均有统计学差异,P值为0.001,EF有显著统计学意义,P值为1.21×10-5;两组下壁ESWT及EDWT、下间壁ESWT比较无差异性,P值分别为0.156、0.316、0.666,下间壁EDWT增厚,与对照组比较有统计学差异,P值为0.049;病变组左室下壁及下间壁SWT明显降低,两组左室下壁及下间壁SWT比较均有显著性差异,P值分别为6.02×10-8、4.02×10-6。结论：右侧冠状动脉严重狭窄导致左室射血分数减少、左室下壁和下间壁收缩期增厚率降低,并对左室下间壁舒张功能有所影响。Objective： To explore the influence of right coronary artery severe stenosis on left ventricular global and regional function. Methods： Coronary CT angiography was performed by 128-slice spiral CT. The patients with coronary artery stenoses more than 75% verified by coronary angiography, were considered as lesion group, and the patients of no coronary artery stenosis as control group. The row data were set 10 phases from 0% to 90% with 10% of R-R interval, and left ventricular ESV, EDV, and EF was measured and calculated, and all data were compared in two groups. All short axial images were reconstructed, then inferior wall thickness and inferoseptal wall thickness were measured, the percentual systolic wall thickening was calculated in end systolic and end diastolic phase of all groups, respectively, the statistical differences were analyzed in the different groups. Results： Compared with ESF and EF of control group, there were statistical differences in those of lesion group, P〈0.001, and EDV of two groups had no significant differences. EDWT of inferoseptal segment in lesion group had a statistically significance, P〈0.05, and there were no significant differences in ESWT of inferoseptal segments, EDWT and ESWT of inferior segments. Comparison of SWT in two groups had significant differences in inferior and inferoseptal wall segments, P〈0.001. Conclusion： severe stenosis of right coronary artery results in reduction of LVEF and SWT in inferior and inferoseptal wall segments, further, regional diastolic function of inferoseptal wall segments are decreased.

关 键 词：冠状动脉造影 计算机断层摄影 左心室 射血分数 心肌收缩期增厚率 

分 类 号：R541.4[医药卫生—心血管疾病] R816.2[医药卫生—内科学]