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64层螺旋CT评估冠脉狭窄与左心室功能的临床应用研究

作者:黄 晗 刘白鹭

所属单位:哈尔滨医科大学附属二院CT室 (黑龙江 哈尔滨 150000)

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摘要

目的 探讨64层螺旋CT用于评估 冠状动脉狭窄与左室心功能相关性的临 床应用价值。方法 以77例冠状动脉狭窄 患者作为研究对象,将其作为观察组, 另选28例同期进行健康体检且无冠状动 脉狭窄者作为对照组进行研究。所有受 检者均接受64层螺旋CT和二维超声心动 图左室功能检查,分别对采用两种方法 所测得的两组患者的左室功能参数进行 分析。结果 77例患者经64层螺旋CT与二 维超声心动图检查所测得的EDV值、ESV 值、SV值、EF值经Peasorn相关性检验表 示具有良好的一致性,r=0.72-0.85。 EDV值、ESV值、EF值、MM 值与冠状动脉 狭窄程度呈显著正相关(r=0.21、0.45、 0.49、0.42,p<0.05);SV值各组间差 异均无统计学意义,与冠脉狭窄程度不 具有相关性(r=0.07,P>0.05)。结论 64层螺旋CT同时评估冠状动脉狭窄与左 室功能具有高度可行性,可准确评价冠 脉狭窄对左室心功能造成的损害,狭窄 程度越严重左心功能损害越大,可为临 床治疗提供重要依据。

Objective To explore the value of 64-slice dynamic volume CT used for assessment of coronary artery stenosis and the correlation of cardiac function of left ventricular. Methods Seventy seven patients with coronary artery stenosis were selected as research subjects, and they were divided into the observation group, 28 candidates undergoing healthy physical examinations without coronary artery stenosis were selected into the control group for research. All subjects underwent 64-slice dynamic volume CT and two-dimensional echocardiography on left ventricular function, and left ventricular function parameters of two groups of patients were analyzed respectively by use of two methods. Results ESV value, EDV value, SV value and EF value measured by 64-slice & 64-lamina dynamic volume CT with two-dimensional echocardiography via Peasorn correlation inspection showed good consistency (r=0.72-0.85). EDV, ESV, EF and MM values were significantly and positively correlated to the degree of coronary artery stenosis (r=0.21, 0.45, 0.49, 0.45, P<0.05). There was no significant difference between groups in SV value, and the extent of coronary stenosis was of no correlation (r=0.07, P>0.07). Conclusion 64-slice dynamic volume CT delivers high feasibility in simultaneously assessing functions of coronary artery stenosis and left ventricular, this technique can accurately the damage of evaluate coronary stenosis on cardiac function of left ventricular, greater damage of left ventricular function will be when the degree of coronary artery stenosis is heavier, providing important basis for clinical treatment

【关键词】冠状动脉狭窄;左室功能; 螺旋CT;超声心动图

【中图分类号】R541.4;R445.3

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.07.015

前言

冠状动脉狭窄是[1]指患者冠状动脉功能受到损害,引起心肌缺血 缺氧,而诱发管腔狭窄或冠状动脉血管壁被黏稠硬化物堵塞所导致血 管腔直径缩小甚至出现闭塞情况。有研究表明[2],冠状动脉粥样硬化 引起粥样硬化斑块发生破裂及血管狭窄是冠心病发病的主要原因,可 以导致患者发生急性血栓,威胁其生命安全。近年来多层螺旋CT技术 在一定程度上有了提高,多层螺旋CT在一次扫描下不仅可以获得冠脉 的解剖学信息,而且还能获得心脏相关功能学信息,对临床评估患者 左室功能情况,了解患者病情、判断预后、选择治疗方式等具有重要 意义[3-4]。鉴于此,哈尔滨医科大学附属二院CT室采用64层螺旋CT评估 冠状动脉狭窄与左室心功能的相关性,取得较好效果,现报告如下。