CTCA定量参数对冠心病患者短期病死预测价值  

Predictive Value of Quantitative Parameters of CTCA for Short-term Mortality in Patients with Coronary Heart Disease

作　　者：董小波[1] 张仲慧[1] 郭庆乐[2] 焦鹏飞[1] DONG Xiaobo;ZHANG Zhonghui;GUO Qingle;JIAO Pengfei(Department of Nuclear Medicine,Kailuan General Hospital,Tangshan,Hebei 063000,China;Department of CT,Kailuan General Hospital,Tangshan,Hebei 063000,China)

机构地区：[1]开滦总医院核医学科,河北唐山063000 [2]开滦总医院CT室,河北唐山063000

出　　处：《临床误诊误治》2024年第8期24-29,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究课题计划项目(20221586)。

摘　　要：目的探讨CT冠状动脉造影(CTCA)定量参数对冠心病患者短期病死预测价值。方法选取2021年3月—2023年3月收治的冠心病200例,比较不同冠状动脉病变程度冠心病患者CTCA定量参数(动脉阻力指数、总斑块负荷和斑块最小密度CT值),分析CTCA定量参数与冠心病患者冠状动脉病变程度相关性,探讨术后1年冠心病患者病死情况,分析CTCA定量参数与冠心病患者短期病死风险关联性,评价CTCA定量参数对冠心病患者短期病死预测价值。结果不同冠状动脉病变程度冠心病患者动脉阻力指数、总斑块负荷逐渐升高,斑块最小密度CT值逐渐降低(P<0.05)。冠心病患者动脉阻力指数、总斑块负荷与疾病类型、病变支数及狭窄程度呈正相关,斑块最小密度CT值与疾病类型、病变支数及狭窄程度呈负相关(P<0.05)。冠心病200例中39例(19.50%)术后1年病死。动脉阻力指数、总斑块负荷和斑块最小密度CT值与冠心病患者短期病死有关(P<0.01)。对冠心病患者短期病死预测的受试者工作特征曲线下面积动脉阻力指数、总斑块负荷和斑块最小密度CT值三者联合明显高于单独预测(P<0.05)。结论CTCA定量参数与冠心病患者冠状动脉病变程度密切相关,且联合各参数预测冠心病患者短期病死价值较高。Objective To investigate the value of quantitative parameters of CT coronary angiography(CTCA)in predicting short-term mortality in patients with coronary heart disease(CHD).Methods In total,200 patients with CHD admitted from March 2021 to March 2023 were selected,and CTCA quantitative parameters(arterial resistance index,total plaque load and minimum CT density of plaques)of CHD patients with different degrees of coronary artery disease(CAD)were compared,and the correlation between CTCA quantitative parameters and the degree of CAD was analyzed.The 1-year postoperative mortality of patients with CHD was analyzed,the correlation between CTCA quantitative parameters and risk of short-term mortality in patients with CHD was explored,and the predictive value of CTCA quantitative parameters for short-term mortality in patients with CHD was evaluated.Results The arterial resistance index and total plaque load of CHD patients with different degrees of CAD increased gradually,and the minimum plaque density decreased gradually(P<0.05).In CHD patients,the arterial resistance index and total plaque load were positively correlated with disease type,number of lesions and degree of stenosis,while the minimum CT density of plaques was negatively correlated with disease type,number of lesions and degree of stenosis(P<0.05).Among 200 CHD patients,39(19.50%)died at one year after surgery.Arterial resistance index,total plaque load and minimum CT density of plaques were associated with the risk of short-term mortality in patients with CHD(P<0.01).The area under the receiver operating characteristic curve of combined detection of arterial resistance index,total plaque load and minimum CT density of plaques was significantly higher than that of individual indicator in prediction(P<0.05).Conclusion CTCA quantitative parameters are closely related to the degree of CAD in patients with CHD,and the value of CTCA parameters in combination is higher in predicting the risk of short-term mortality in patients with CHD.

关 键 词：冠心病 CT冠状动脉造影 定量参数 动脉阻力指数 总斑块负荷 斑块最小密度CT值 冠状动脉病变程度 病死 

分 类 号：R541.4[医药卫生—心血管疾病]