冠状动脉CT血管成像定量斑块参数评估冠心病心肌缺血性损伤的价值  

The value of quantitative plaque parameters on coronary CT angiography in evaluating myocardial ischemic injury in coronary heart disease

作　　者：余竹萍 熊俊峰[3] 汪子平 吴秀芬 YU Zhuping;XIONG Junfeng;WANG Ziping;WU Xiufen(Department of Radiology,Quzhou Hospital of TCM,Quzhou 324000,China)

机构地区：[1]衢州市中医医院放射科,324000 [2]衢州市中医医院心内科,324000 [3]衢州市人民医院放射科

出　　处：《心电与循环》2021年第5期492-495,500,共5页Journal of Electrocardiology and Circulation

基　　金：衢州市科技计划项目(2021Z079)。

摘　　要：目的探讨冠状动脉CT血管成像(CCTA)定量斑块参数评估冠心病心肌缺血性损伤的价值。方法选择2019年1月至2020年6月衢州市中医医院行冠脉造影和CCTA检查的冠心病患者130例,根据入院48 h内超声心动图检查及心肌酶检测结果分为心肌损伤组(86例)和无心肌损伤组(44例)。测定斑块长度(PL)、最小管腔面积(MLA)、最大面积狭窄率(MAS)、斑块负荷(TPB)、斑块总体积(TPV)、钙化斑块体积(CPV)、钙化斑块占比(CPR)、脂质斑块体积(LPV)、脂质斑块占比(LPR)、纤维斑块体积(FPV)、纤维斑块占比(FPR),采用多元线性回归分析定量斑块参数与心肌缺血性损伤的关系。结果心肌损伤组患者MAS、TPB、TPV、LPV、LPR、FPV高于无心肌损伤组,CPR低于无心肌损伤组,差异均有统计学意义(均P<0.05)。多元线性回归分析显示MAS、TPB、TPV、LPV、LPR、FPV是影响冠心病心肌缺血性损伤的主要因素(均P<0.05)。结论CCTA定量斑块参数可作为临床诊断心肌缺血性损伤的辅助方式。Objective To evaluate the value of quantitative plaque parameters on coronary CT angiography(CCTA)in evaluating myocardial ischemic injury in coronary heart disease.Methods A total of 130 patients with coronary heart disease who underwent coronary angiography and CCTA examination in Quzhou Hospital of TCM from January 2019 to June 2020 were enrolled and divided into myocardial injury group(86 cases)and non-myocardial injury group(44 cases)according to the results of echocardiography and myocardial enzymes measured within 48 hours after admission.Plaque length(PL),minimal lumen area(MLA),Maximum area stenosis(MAS),total plaque burden(TPB),total plaque volume(TPV),calcified plaque volume(CPV),calcified plaque ratio(CPR),lipid plaque volume(LPV),lipid plaque ratio(LPR)and fibrotic plaque volume(FPV),fibrotic plaque ratio(FPR)were measured.Multiple linear regression was used to analyze the relationship between quantitative plaque parameters and myocardial ischemic injury.Results MAS,TPB,TPV,LPV,LPR and FPV were significantly higher and CPR was significantly lower in myocardial injury group than in non-myocardial injury group(all P<0.05).Multiple linear regression analysis showed that MAS,TPB,TPV,LPV,LPR and FPV were the main factors affecting myocardial ischemic injury(all P<0.05).Conclusion CCTA-derived quantitative plaque parameters can be used as an auxiliary method for clinical diagnosis of myocardial ischemic injury.

关 键 词：冠心病 冠状动脉CT血管成像 心肌缺血性损伤 

分 类 号：R541.4[医药卫生—心血管疾病]