冠状动脉CT血管成像联合CT-FFR对冠心病心肌缺血影响因素的研究  

Study on the influencing factors of coronary CT angiography combined with CT-FFR on myocardial ischemia in coronary heart disease

作　　者：徐敏[1] 瞿华[1] XU Min;QU Hua(Department of Radiology,Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medicine University,Hangzhou 310007,Zhejiang,China)

机构地区：[1]浙江中医药大学附属杭州市中医院放射科,浙江杭州3100071

出　　处：《中国现代医生》2024年第25期66-69,共4页China Modern Doctor

摘　　要：目的应用冠状动脉CT血管成像(coronary CT angiography,CCTA)联合冠状动脉CT血流储备分数(coronary CT angiography derived fractional flow reserve,CT-FFR)探讨冠心病患者心肌缺血的影像学特征,并探讨冠心病患者心肌缺血的影响因素。方法回顾性选取2023年1月至11月于浙江中医药大学附属杭州市中医院就诊并行CCTA检查的86例患者,根据测量的CT-FFR值将其分为缺血组(CT-FFR≤0.80,45例)与非缺血组(CT-FFR>0.80,41例),比较两组患者的斑块特征,采用多因素Logistic回归分析探讨冠心病患者心肌缺血的影响因素。结果缺血组患者的糖尿病占比显著高于非缺血组(P<0.05)。共有150支冠状动脉显示有斑块,斑块最常见部位为左前降支(114个)。对212个斑块进行分析,其中缺血组68个斑块,非缺血组144个斑块。非缺血组钙化斑块占比显著高于缺血组(P<0.05);缺血组管腔狭窄程度、斑块体积、脂类成分占比、纤维脂类成分体积均显著大于非缺血组,斑块纤维成分体积显著小于非缺血组(P<0.05)。多因素Logistic回归分析结果显示,管腔狭窄程度(OR=1.054,P=0.026)和斑块体积(OR=1.027,P=0.048)均是冠心病患者心肌缺血的的影响因素。结论管腔狭窄程度及斑块体积均是冠心病患者心肌缺血的影响因素,可对此类患者进行针对性的治疗。Objective To explore the imaging features of myocardial ischemia in patients with coronary heart disease by coronary CT angiography(CCTA)combined with coronary CT angiography derived fractional flow reserve(CT-FFR),and to find out the influencing factors of myocardial ischemia in patients with coronary heart disease.Methods A total of 86 patients who received CCTA examination in Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medicine University from January to November 2023 were retrospectively selected.According to the measured CT-FFR value,they were divided into ischemia group(CT-FFR≤0.80,45 cases)and non-ischemia group(CT-FFR>0.80,41 cases).The plaque characteristics of two groups were compared,and the influencing factors of myocardial ischemia in patients with coronary heart disease were investigated by multivariate Logistic regression analysis.Results The proportion of diabetes mellitus in ischemia group was significantly higher than that in non-ischemia group(P<0.05).A total of 150 coronary arteries showed plaque,with the majority located in the left anterior descending artery(114).A total of 212 plaques were analyzed,including 68 plaques in ischemic group and 144 plaques in non-ischemic group.The proportion of calcified plaque in non-ischemic group was significantly higher than that in ischemic group(P<0.05).The degree of vascular stenosis,the volume of plaque,the proportion of lipid components and the volume of fibrous lipid components in ischemic group were significantly higher than those in non-ischemic group,and the volume of plaque fiber components was significantly lower than that in non-ischemic group(P<0.05).Multivariate Logistic regression analysis showed that the degree of vascular stenosis(OR=1.054,P=0.026)and plaque volume(OR=1.027,P=0.048)were influencing factors of myocardial ischemia in patients with coronary heart disease.Conclusion The degree of vascular stenosis and volume of plaque are both factors affecting myocardial ischemia in patients with coronary heart disease,and targeted

关 键 词：冠状动脉CT血管成像 心肌缺血 斑块特征 血流储备分数 

分 类 号：R814.43[医药卫生—影像医学与核医学] R541.4[医药卫生—放射医学]