CT冠状动脉成像在冠心病诊断及预后评估中的应用价值  

The Application Value of CT Angiography in the Diagnosis and Prognosis Evaluation of Coronary Heart Disease

作　　者：王芳[1] 覃群 韦迎娜[1] WANG Fang;QIN Qun;WEI Ying-na(Department of Cardiology,The Third People's Hospital of Hainan Province,Sanya 572000,Hainan Province,China)

机构地区：[1]海南省第三人民医院心血管内科,海南三亚572000 [2]海南省第三人民医院放射科,海南三亚572000

出　　处：《中国CT和MRI杂志》2020年第9期93-95,99,共4页Chinese Journal of CT and MRI

基　　金：三亚市医疗卫生科技创新项目(项目编号:2015YW36)。

摘　　要：目的分析CT冠状动脉成像在冠心病诊断及预后评估中的应用价值。方法回顾性分析2017年3月至2018年6月海南省第三人民医院收治的104例疑似冠心病患者临床资料,均予以CT冠状动脉成像(CTA)及冠状动脉造影(CAG)检查,以CAG诊断结果为金标准,分析CTA诊断对第1~4段、第5~7段、第8~10段、第11~15段冠状动脉血管的诊断效能,并依据1年随访结果将其分为发生心脏事件组、未发生心脏事件组,比较两组的CTA影像资料,分析CTA对冠心病患者预后的评估价值。结果以CAG为金标准,CTA诊断第1~4段、第5~7段、第8~10段、第11~15段冠状动脉血管的灵敏度为91.14%~99.34%,特异度为81.25%~94.90%,准确度为91.16%~97.62%,总体诊断灵敏度、特异度、准确度分别为91.57%、87.72%、91.00%;随访1年,发生心脏事件组冠状动脉斑块、斑块位于冠状动脉近端、2~3支血管狭窄≥50%,钙化斑块、纤维软斑块率高于无心脏事件组(P<0.05),两组斑块位于左主干比例比较差异无统计学意义(P>0.05)。结论 CTA用于冠心病的诊断及预后中有较高评估价值,利于针对性工作的顺利开展,值得在临床推广实践。Objective To analyze the application value of CT angiography (CTA) in the diagnosis and prognosis evaluation of coronary heart disease.Methods The clinical data of 104 patients with suspected coronary heart disease admitted to the hospital between March 2017 and June 2018 were retrospectively analyzed.All of the patients underwent CTA and coronary angiography (CAG).With the diagnostic results of CAG as the golden standard,the diagnostic efficiencies of CTA for the 1st to 4th,the 5th to 7th,the 8th to 10th and the 11th to 15th coronary arteries were analyzed.The patients were divided into the cardiac event group and the non-cardiac event group according to the 1-year follow-up results.CTA imaging data of the two groups were compared to analyze the value of CTA in evaluating the prognosis of patients with coronary heart disease.Results With CAG as the golden standard,the sensitivities of CTA for diagnosis of the 1st to 4th,the 5th to 7th,the 8th to 10th and the 11th to 15th coronary arteries were between 91.14% and 99.34%,and the specificities were between 81.25% and 94.90%.The accuracy rates were between 91.16% and 97.62%.The overall diagnostic sensitivity,specificity and accuracy were 91.57%,87.72% and 91.00%.1 year follow-up found that the rates of coronary artery plaques,plaques located in proximal coronary artery,2 to 3 vascular stenosis ≥50%,calcified plaque and fibrous soft plaque in the cardiac event group were higher than those in the non-cardiac event group (P<0.05).There was no statistically significant difference between the two groups in the proportion of plaques in the left main trunk (P>0.05).Conclusion CTA is of great value in the diagnosis and prognosis evaluation of coronary heart disease.It is conducive to the smooth development of targeted work and worthy of clinical application.

关 键 词：CT冠状动脉成像 冠心病 诊断 预后 

分 类 号：R541.4[医药卫生—心血管疾病] R445.3[医药卫生—内科学]