冠状动脉CT血管成像CCTA斑块定量分析评估老年冠心病患者高危斑块进展的价值  

Value of CCTA Quantitative Plaque Analysis in Evaluating High-risk Plaque Progression in Elderly Patients with Coronary Heart Disease

作　　者：张俊彪[1] 郭军霞[1] 刘辉[1] ZHANG Jun-biao;GUO Jun-xia;LIU Hui(Ward II,Department of Cardiovascular Medicine,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院心血管内科二病区,河南新乡453100

出　　处：《中国CT和MRI杂志》2024年第4期69-71,共3页Chinese Journal of CT and MRI

基　　金：2021年河南省医学科技攻关计划联合共建项目和软科学项目(LHGJ20210503)。

摘　　要：目的探讨冠状动脉CT血管成像(CCTA)斑块定量分析对于老年冠心病患者高危斑块进展的评估价值。方法纳入2020/08-2022/08该院心内科接诊的90例老年冠心病病例,均接受CCTA检查,按照是否为高危斑块分为高危组、非高危组,对于高危斑块依据1年随访后斑块进展情况分为进展组、未进展组,对比其CCTA斑块定量参数差异及对高危斑块进展的预测价值。结果CCTA检查发现高危斑块发生率达83.33%(75/90),其中点状钙化斑块64例(71.11%),低密度斑块38例(42.22%),重塑指数RI、脂质斑块负荷大于非高危组(P<0.05),高危组基于CCTA血流储备分数(FFRct)及冠脉周围脂肪衰减指数(FAI)均低于非高危组(P<0.05);进展组的斑块总体积和非钙化斑块体积、狭窄程度、RI、脂质斑块负荷均大于无进展组(P<0.05),进展组最小管腔面积、FFRct、FAI小于无进展组(P<0.05);斑块总体积和非钙化斑块体积、狭窄程度、最小管腔面积、FFRct、FAI、RI、脂质斑块负荷及各项联合预测老年冠心病病例的高危斑块进展ROC曲线下面积分别是0.807、0.801、0.788、0.756、0.763、0.768、0.775、0.806、0.872。结论CCTA斑块定量分析评估老年冠心病患者高危斑块及其进展有重要意义,值得在临床推广应用。Objective To discuss the value of coronary computed tomography angiography(CCTA)quantitative plaque analysis in evaluating high-risk plaque progression in elderly patients with coronary heart disease.Methods Ninety elderly patients with coronary heart disease who were admitted to cardiology department of the hospital from August 2020 to August 2022 were selected.All received CCTA.They were divided into high-risk group and non-high-risk group according to the nature of plaque.Patients with high-risk plaques were divided into progression group and non-progression group according to the one-year follow-up results.Plaque quantitative parameters of CCTA were compared between groups,and the predictive value of CCTA quantitative plaque analysis in high-risk plaque progression was analyzed.Results CCTA found that the incidence of high-risk plaques was 83.33%(75/90).There were 64(71.11%)cases of punctate calcified plaques and 38(42.22%)cases of low-density plaques.Compared with the non-high-risk group,RI and lipid plaque load were higher in the high-risk group(P<0.05).CCTA-derived fractional flow reserve(FFRct)and pericoronary fat attenuation index(FAI)were lower in the high-risk group(P<0.05).Compared with the non-progression group,total plaque volume,non-calcified plaque volume,stenosis degree,RI and lipid plaque load were greater in the progression group(P<0.05).The minimum lumen area,FFRct and FAI were smaller in the progression group(P<0.05).The areas under the ROC curves of total plaque volume,non-calcified plaque volume,stenosis degree,minimum lumen area,FFRct,FAI,RI,lipid plaque load,and their combination for predicting high-risk plaque progression in elderly patients with coronary heart disease were 0.807,0.801,0.788,0.756,0.763,0.768,0.775,0.806 and 0.872.Conclusion CCTA quantitative plaque analysis is of great significance for evaluating high-risk plaques and their progression in elderly patients with coronary heart disease.

关 键 词：CCTA 斑块定量分析 老年 冠心病 高危斑块 进展 

分 类 号：R541.4[医药卫生—心血管疾病]