目的 分析多层螺旋CT在评估冠 状动脉重度狭窄患者心功能中的应用价 值。方法 根据多层螺旋CT血管造影(CTA) 检查结果和血管管腔直径判断冠脉狭窄程 度，并根据判断结果将180例冠状动脉狭 窄患者分为四组：轻度狭窄组(n=38)、中 度狭窄组(n=58)、重度狭窄组(n=48)、 闭塞组(n=36)，均行多层螺旋CT心脏扫 描，测量左心房功能参数，包括左心房 舒张末期容积(LAEDV)、收缩末期容积 (LAESV)、左室每搏输出量(LVSV)、左室 心肌质量(LVMM)、左心房射血分数(LAEF) 等，并行超声心动图检查测量上述参数。 结果 多层螺旋CT检查中各项左心房功能 参数与超声心动图检查结果比较无统计学 意义(P＞0.05)。多层螺旋CT检查结果显 示轻度狭窄组、中度狭窄组、重度狭窄 组、闭塞组左心室各参数LAEDV、LAESV、 LVSV、LVMM、LAEF比较差异有统计学意义 (P＜0.05)；轻度狭窄组、中度狭窄组左 心室各参数比较差异不显著(P＞0.05)， 重度狭窄组、闭塞组左心室各参数比较差 异不显著(P＞0.05)，但与轻度狭窄组和 中度狭窄组相比，重度狭窄组、闭塞组 LAEDV、LAESV、LVMM显著较高，LVSV、 LAEF显著较低(P＜0.05)。随冠状动脉狭 窄程度加重LVEDV、LVESV、LVMM水平明显 升高，呈正相关(r=0.38，0.35，0.42，P ＜0.05)，LVEF、LVSV水平明显下降，呈 负相关(r=-0.32，-0.41，P＜0.05)。结 论 多层螺旋CT定量评价冠状动脉重度狭 窄及左室收缩功能准确、可靠，可同时评 估冠状动脉狭窄情况和左心室功能。

Objective To evaluate the application value of multi-slice spiral CT in assessing cardiac function in patients with severe coronary artery stenosis. Methods The coronary artery stenosis degree was determined by the multi-slice spiral CT angiography (CTA) examination results and the vascular lumen diameter, and according to this judgment results, 180 cases of patients with coronary artery stenosis were divided into four groups: the mild stenosis group (n=38), the moderate stenosis group (n=58), the severe stenosis group (n=48) and the occlusion group (n=36). And the four groups were performed multi-slice spiral CT cardiac scanning. The left atrial function parameters were measured, including left atrial end diastolic volume (LAEDV), end-systolic volume (LAESV), left ventricular stroke volume (LVSV), left ventricular mass (LVMM), left atrial ejection fraction (LAEF), and so on. And the echocardiography was used to measure the abovementioned parameters. Results There were no significant differences in left atrial function parameters between echocardiography and multi-slice spiral CT (P>0.05). The results of multi-slice spiral CT showed that there were significant differences in left ventricular parameters ( LAEDV, LAESV, LVSV, LVMM and LAEF) between the mild stenosis group, the moderate stenosis group, the severe stenosis group and the occlusion group (P<0.05). There was no significant difference in the left ventricle parameters between the mild stenosis group and the moderate stenosis group, and there was no significant difference in the left ventricle parameters between the severe stenosis group and the occusion group (P>0.05), but the levels of LAEDV, LAESV and LVMM were significantly higher and the levels of LVSV and LAEF were significantly lower in the severe stenosis group and the occlusion group compared with those in the mild stenosis group and the moderate stenosis group (P<0.05). With the coronary artery stenosis degree increased, the levels of LVEDV, LVESV and LVMM were increased and they were positively correlated (r= 0.38, 0.35, 0.42, P<0.05), and the levels of LVEF and LVSV were decreased and they were negatively correlated (r= -0.32, -0.41, P<0.05). Conclusion Multi-slice spiral CT quantitative assessment is accurate and reliable in the severe coronary artery stenosis and left ventricular systolic function, and can simultaneously assess coronary artery stenosis and left ventricular function.