动态负荷心肌CTA扫描评估中重度冠心病风险患者心肌缺血的价值研究  

The value of dynamic load myocardial CTA scanning in evaluating myocardial ischemia in patients with moderate to severe coronary heart disease risk

作　　者：左冠宇 刘伯胜 Zuo Guanyu;Liu Bosheng(Daye People's Hospital,Daye,Hubei435100,China;Lu'an Shili Hospital,Lu'an,Anhui 237000,China)

机构地区：[1]湖北省大冶市人民医院,湖北大冶435100 [2]安徽省六安市世立医院,安徽六安237000

出　　处：《首都食品与医药》2024年第20期98-101,共4页Capital Food Medicine

摘　　要：目的分析动态负荷心肌CTA扫描评估中重度冠心病风险患者心肌缺血的价值.方法选取2021年1月-2023年12月期间我院接收的100例中重度冠心病风险患者,所有患者均接受动态负荷心肌CTA与冠状动脉CT血管成像(CCTA)扫描,参考冠状动脉血管造影(CAG)检查结果,分析不同检查方式在中重度冠心病风险患者心肌缺血中的诊断效能.结果100例患者经CCTA检查57例存在心肌缺血,43例未发现心肌缺血情况,动态负荷心肌CTA检查59例存在心肌缺血,41例未发现心肌缺血情况,联合检查61例存在心肌缺血,39例未发现心肌缺血情况;三种检查方式诊断特异性接近(P>0.05),联合检查诊断灵敏性和准确度明显比单一CCTA、动态负荷心肌CTA扫描高(P<0.05);联合检查斑块长度、管腔狭窄比例均高于CCTA(P<0.05).结论中重度冠心病风险患者心肌缺血临床诊断中动态负荷心肌CTA扫描评估虽然可以为医生提供更多诊断信息,但是仍旧存在误诊、漏诊情况,在临床诊断中可以采取动态负荷心肌CTA、冠状动脉CT血管成像联合诊断,从而确保诊断准确性,方便医生判断患者心肌缺血情况,合理采取对症治疗措施.Objective To analyze the value of dynamic load myocardial CTA scanning in evaluating myocardial ischemia in patients with moderate to severe coronary heart disease risk.Methods 100 patients with moderate to severe coronary heart disease risk and myocardial ischemia admitted to our hospital between January 2021 and December 2023 were selected.All patients underwent dynamic load myocardial CTA and coronary artery CT angiography(CCTA)scans,and the diagnostic efficacy of different examination methods in myocardial ischemia in patients with moderate to severe coronary heart disease risk was analyzed based on the results of coronary angiography(CAG)examination.Results Among the 100 patients,57 cases were found to have myocardial ischemia through CCTA examination,43 cases were not found to have myocardial ischemia,59 cases were found to have myocardial ischemia through dynamic load myocardial CTA examination,41 cases were not found to have myocardial ischemia,61 cases were found to have myocardial ischemia through combined examination,and 39 cases were not found to have myocardial ischemia;the diagnostic specificity of the three examination methods is similar(P>0.05),and the combined examination has significantly higher diagnostic sensitivity and accuracy than single CCTA and dynamic load myocardial CTA scan(P<0.05);the joint examination showed that the length of plaques and the proportion of luminal stenosis were higher than those of CCTA(P<0.05).Conclusion In the clinical diagnosis of patients with severe coronary heart disease risk and myocardial ischemia,dynamic load myocardial CTA scanning evaluation can provide doctors with more diagnostic information,but there are still misdiagnosis and missed diagnoses.In clinical diagnosis,a combination of dynamic load myocardial CTA and coronary artery CT angiography can be used to ensure diagnostic accuracy,facilitate doctors to judge the patient's myocardial ischemia situation,and adopt targeted treatment measures reasonably.

关 键 词：动态负荷心肌CTA 冠状动脉CT血管成像 冠状动脉血管造影 重度冠心病 心肌缺血 诊断效能 

分 类 号：R541.4[医药卫生—心血管疾病]