摘要
目的探究冠状动脉(冠脉)电子 计算机断层扫描血管造影(CTA)评估心绞 痛患者斑块性质及其与心血管事件的相关 性。方法 回顾性分析我院216例心绞痛患 者相关资料,并根据其临床资料分为稳定 型心绞痛组(SAP组,78例)及非稳定型心 绞痛组(UAP组,138例)。比较两组斑块性 质差异,并分析两组心血管事件发生情况 与斑块性质的相关性。结果 SAP组斑块以 钙化斑块为主;UAP组则以软斑块为主; 两组混合斑块率比较,差异无统计学意义 (P>0.05);SAP组软斑块率明显低于UAP 组(P<0.05),钙化斑块率则高于UAP组 (P<0.05)。SAP组共发生8例心血管事件 (10.26%),UAP组共发生心血管事件41例 (29.71%);且两组组内发生心血管事件 与未发生心血管事件患者混合斑块率比 较,差异均无统计学意义(P>0.05);组 内发生心血管事件患者软斑块率明显高于 未发生心血管事件患者(P<0.05),而钙 化斑块率低于未发生心血管事件患者(P <0.05)。结论 软斑块与心绞痛患者发生 心血管事件关系密切,而冠脉CTA能有效 评估斑块性质,对辅助预测患者预后情况 有一定作用。
Objective To explore the plaque properties of patients with angina pectoris evaluated by coronary computerized tomography angiography (CTA) and their correlation with cardiovascular events. Methods The related data of 216 patients with angina pectoris in our hospital were analyzed retrospectively. According to the clinical data, they were divided into stable angina pectoris group (SAP group, 78 cases) and unstable angina pectoris group (UAP group, 138 cases). The differences in plaque properties were compared between the two groups, and the correlation between cardiovascular events and plaque properties was analyzed. Results The plaques were mainly calcified plaques in SAP group, and were soft plaques in UAP group. There was no statistically significant difference in the rate of mixed plaques between the two groups (P>0.05). The soft plaques rate in SAP group was significantly lower than that in UAP group (P<0.05) while the calcified plaques rate was higher than that in UAP group (P<0.05). There were 8 cases (10.26%) of cardiovascular events in SAP group and were 41 cases (29.71%) of cardiovascular events in UAP group. There was no significant difference in the mixed plaques rate between patients with cardiovascular events and patients without cardiovascular events within the two groups (P>0.05). The soft plaques rate in patients with cardiovascular events was significantly higher than that in patients without cardiovascular events (P<0.05), but the calcified plaques rate was lower than that in patients without cardiovascular events (P<0.05). Conclusion Soft plaque is closely related to cardiovascular events in patients with angina pectoris. Coronary CTA can effectively evaluate the plaque properties and play a role in predicting the prognosis of patients.
【关键词】CTA;冠状动脉;斑块性质; 心绞痛;心血管事件
【中图分类号】R781.64
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2018.12.020
前言
稳定型心绞痛(SAP)及非稳定型心绞痛(UAP)的发生发展均与冠状 动脉(冠脉)粥样斑块形成导致的管腔狭窄有关,且斑块的不稳定性为 引起急性心血管事件的主要危险因素,故评估心绞痛患者斑块性质对 预测患者预后有一定意义[1]。冠状动脉造影(CAG)为临床评估心绞痛的 重要影像学方法,但仅能诊断患者管腔狭窄状况,无法对斑块性质做 出判断[2]。而电子计算机断层扫描血管造影(CTA)不仅能观察斑块成 分,也能评估斑块稳定性[3]。基于此,本研究回顾性分析我院216例心 绞痛患者相关资料,以评估冠脉CTA对斑块性质的诊断价值,及斑块性 质与心血管事件的相关性,现报告如下。
中国CT和MRI杂志
第16卷, 第 12 期
2018年12月
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