目的 研究64层螺旋CT对急性冠 脉综合征(ACS)患者斑块成分的临床检测 价值。方法 选取2013年5月至2015年1 月我院收治的冠心病患者84例为研究对 象，均进行64层螺旋CT冠脉造影检查、 选择性冠状动脉造影检查(SAG)、心电 图检查，以SAG结果作为“金标准”， 评价64层螺旋CT预测冠状动脉狭窄的敏 感度、特异度、准确度，同时根据64 层螺旋CT检查结果将其分为ACS组和非 ACS组，利用冠脉斑块分析软件对患者 斑块成分进行分析，比较两组斑块类 型、斑块成分、斑块CT值及延迟扫描后 CT值的变化。结果 64层螺旋CT预测冠 状动脉狭窄的灵敏度为96.83％，特异 度为80.95％，准确度为92.86％；斑块 成分分析显示两组Ⅰ型斑块比例比较无 显著差异(P>0.05)，两组Ⅱ型、Ⅲ型斑 块比例比较有显著差异(P<0.05)，ACS 组斑块中的脂质成分(66.74±5.28)％ 较非ACS组高(P<0.05)，ACS组斑块纤 维成分(31.49±1.28)％与钙化成分 (4.79±1.28)％低于非ACS组(P<0.05)； ACS组斑块CT值、延迟扫描后CT值、下降 值均较非ACS组低(P均<0.05)。结论 64 层螺旋CT能有效识别ACS患者的斑块形 态，鉴别其稳定性，值得在临床推广应 用。

Objective To study clinical detection value of 64 multi-slice CT to plaques composition of patients with acute coronary syndrome(ACS). Methods 84 patients with coronary heart disease treated in our hospital from May 2013 to January 2015 were selected as the research objects, all patients underwent 64 multi-slice CT coronary angiography examination, selective coronary angiography examination(SAG), electrocardiographic examination, SAG results were served as the gold standard, sensitivity, specificity and accuracy of 64 multi-slice CT in the forecast of coronary artery stenosis were estimated, patients were divided into ACS group and non ACS group according to 64 multi-slice CT inspection results at the same time, coronary plaque analysis software was used to analyze plaques composition, plaques type, plaques composition, plaques CT value, changes of CT value after delayed sweep in the two groups were compared. Results Sensitivity of 64 multi-slice CT in the forecast of coronary artery stenosis was 96.83%, specificity was 80.95%, accuracy was 92.86%; plaques composition analysis showed that there was no significant difference in Ⅰ type plaques proportion in the two groups (P>0.05), there was a significant difference in Ⅱ type and Ⅲ type plaques proportion in the two groups(P<0.05), lipid composition of plaques in ACS group (66.74±5.28)% was significantly higher than non ACS group (P<0.05), fiber content (31.49±1.28)% and calcification composition (4.79±1.28)% of ACS group were significantly lower than non ACS group(P<0.05), plaques CT value, CT value after delayed sweep, decreased value of ACS group were significantly lower than non ACS group (all P<0.05). Conclusion 64 multi-slice CT can identify plaque form of ACS patients effectively, identify its stability, is worth for application in clinical experience.