冠状动脉双源计算机断层摄影术血管功能成像评价冠心病的初步研究  

Preliminary Evaluation of Coronary Artery Disease by Dual-source CT Functional Imaging in Relevant Patients

作　　者：熊青峰[1] 马小静[1] 陈艳[1] 陈鑫[1] 李炜[1] 双东思[2] 许娟[1] 李林[1] 陈险峰[1] XIONG Qing-feng MA Xiao-jing CHEN Yan CHEN Xin LI Wei SHUANG Dong-si XU Juan LI Lin CHEN Xian-feng(Imaging Center, Wuhan Asia Heart Hospital, Wuhan （430000）, Hubei, Chin)

机构地区：[1]武汉亚洲心脏病医院影像中心,湖北省武汉市430000 [2]武汉亚洲心脏病医院介入中心,湖北省武汉市430000

出　　处：《中国循环杂志》2016年第9期836-839,共4页Chinese Circulation Journal

基　　金：2015年湖北省自然科学基金资助(WJ2015MB170)

摘　　要：目的:运用冠状动脉双源计算机断层摄影术(CT)血管功能成像初步评价冠心病。方法:我院自2014-09至2015-10期间在临床疑似非ST段抬高型急性冠状动脉综合征患者200例中入选经双源CT血管造影(Dual-source CT angiography,DSCTA)判断左冠状动脉前降支管腔狭窄为临界值的患者共57例,CT检查后1周内行选择性冠状动脉造影(Selective Coronary Angiography,SCA)证实其狭窄程度,并行导管法测量血流储备分数(FFR),以FFR 0.80为临界值将57例患者分为FFR<0.80组27例和FFR≥0.80组30例,测量左心室前壁、侧壁心肌及左心室腔CT值及舒张期、收缩期节段室壁厚度,比较各组前壁与侧壁相对CT值差异,以及前壁与侧壁舒张末期心肌厚度及室壁增厚率。结果:(1)FFR<0.80组前壁与侧壁心肌比较:相对CT值(P=0.000)、舒张末期心肌厚度(P=0.000)、心肌增厚率(P=0.001)均减低,差异均有统计学意义。(2)FFR≥0.80组前壁与侧壁心肌比较:相对CT值(P=0.000)、舒张末期心肌厚度(P=0.018)均减低,差异均有统计学意义;心肌增厚率(P=0.186)差异无统计学意义。(3)FFR<0.80组与FFR≥0.80组比较:前壁相对CT值(P<0.05)及心肌增厚率(P<0.001)均减低,差异均有统计学意义,而心肌舒张末期心肌厚度差异无统计学意义(P值为0.964)。结论:CT测定的数据具有临床治疗病例选择的参考价值。Objective： To preliminarily evaluate coronary heart disease （CAD） by dual-source CT vascular functional imaging in relevant patients. Methods： A total of 200 patients with suspected non-ST elevation acute coronary syndrome （NSTE-ACS） in our hospital from 2014-09 to 2015-10 were enrolled, 57 of them received dual-source CT angiography （DSCTA） and diagnosed for critical value of left anterior descending （LAD） stenosis; the patients were further examined by selective coronary angiography （SCA） within 1 week to conifrm the degree of stenosis. Meanwhile, fractional lfow reserve （FFR） was measured and taking FFR 0.8 as cut off point, the patients were divided into 2 groups： FFR〈0.8 group,n=27 and FFR≥0.8 group,n=30. The values of left ventricular anterior wall, side wall, left ventricular cavity and the segmental thickness in diastolic and systolic stages were measured; relative CT value between ventricular anterior wall and side wall was compared, myocardium thickness at the end-diastolic stage was also compared. Results：①In FFR〈0.8 group, compared with the side wall, anterior wall had decreased relative CT value （P=0.000）, myocardium thickness at the end-diastolic stage （P=0.000） and myocardial wall thickening rate （P=0.001）.②In FFR≥0.8 group, compared with the side wall, anterior wall had decreased relative CT value （P=0.000）, myocardium thickness at the end-diastolic stage （P=0.018）, while similar myocardial wall thickening rate （P=0.186）.③Compared with FFR≥0.8 group, the patients in FFR〈0.8group presented reduced relative CT value in anterior wall （P〈0.05） and myocardial wall thickening rate （P〈0.001）, while similar myocardium thickness at the end-diastolic stage （P=0.964）. Conclusion： CT information may provide the reference value for treating patients in clinical practice.

关 键 词：冠状动脉疾病 体层摄影术 X线计算机 心血管造影术 血流储备 

分 类 号：R54[医药卫生—心血管疾病]