目的 探讨冠状动脉CT造影对冠 状动脉慢性完全闭塞病变(CTO)冠脉介入 治疗(PCI)成败的预测价值。方法 回顾性 分析我院收治的250例CTO患者临床资料， 按照年龄的大小分为青中年组与老年组， 其中≤60岁者共126例，纳入青中年组； >60岁者124例患者，纳入老年组。比较两 组患者冠状动脉造影的血管特征、介入 治疗情况、手术成功率、术前后超声心动 图情况。结果 老年组三支病变及合并左 主干病变支数多于青中年组(P<0.05)。 青中年组左前降支、右冠状动脉病变多 于老年组(P<0.05)。老年组患者靶血管 迂曲和钙化发生率显著高于中青年患者 (P<0.05)。老年组患者桡动脉入路率显著 高于中青年组(P<0.05)，桡动脉+股动脉 入路率显著低于中青年组(P<0.05)。指引 导管直径、逆向导丝技术比较差异统计学 意义(P>0.05)。两组患者手术成功率比较 差异无统计学意义(P>0.05)。手术前后 青中年组患者LVEDD比较差异无统计学意 义(P>0.05)，LVEF高于术前(P<0.05)。 手术前老年组患者LVEDD显著高于术后 (P<0.05)，LVEF与术后比较差异无统计学 意义(P>0.05)。术前，两组患者LVEDD比 较差异无统计学意义(P<0.05)，老年组患 者LVEF高于青中年组(P<0.05)。术后， 青中年组LVEDD高于老年组(P<0.05)， LVEDD与老年组比较差异无统计学意义 (P>0.05)。结论 冠状动脉CT造影可提高 冠状动脉慢性完全闭塞病变PCI治疗成功 率，明确病变部位，指导穿刺。

Objective To investigate the predictive value of coronary CT angiography in percutaneous coronary intervention (PCI) treatment for chronic total occlusion (CTO) lesions. Methods The clinical data of 250 CTO patients admitted to our hospital were analyzed retrospectively. The patients were divided into two groups according to their age. Among them, 126 cases(patients younger than 60 years old) were included in the youth group, and 124 cases(patients older than 60 years old) were included in the elderly group. The features of coronary artery angiography, interventional treatment efficacy, success rate of surgery, and echocardiography before and after surgery were compared between the two groups. Results The incidence rate of the three-vessel lesions and left main lesions in the elderly group was higher than that of the youth group (P<0.05). The coronary artery lesions of the left anterior descending and right coronary lesions were more in the elderly group than in the youth group (P<0.05). The incidence rate of the proximal vessel severe tortuosity and calcification of the elderly group was higher than that of the youth group (P<0.05). The elderly group had higher incidence rate of disease with the transradial approach as well as lower incidence rate of transradial approach+ transfemoral approach than those of the youth group (P<0.05). No difference as found in the size of guiding catheter, retrograde wire technique and success rate of surgery (P>0.05). The LVEDD in the youth group had no difference before and after treatment, and the LVEF was increased after treatment (P<0.05). The LVEF in the elderly group had no difference before and after treatment, and the LVEDD was increased after treatment (P<0.05). The LVEDD of the two groups had no difference within groups (P>0.05), and was higher in the youth group than in the elderly group (P<0.05). The LVEF of the two groups had no difference within groups (P>0.05), and was lower in the youth group than in the elderly group (P<0.05). Conclusion The coronary CT angiography can improve the success rate of PCI, and clarify the lesion location, and guide the puncture for CTO patients.