目的 探索CT血管造影(CTA)应用 于急性冠脉综合征(ACS)患者介入术治疗 前后的临床价值。方法 回顾性分析126 例行介入术治疗的ACS临床资料，以数字 血管减影造影(DSA)为金标准，分析CTA 对ACS患者术前血管狭窄程度分级诊断准 确性；根据术后6个月内支架内再狭窄 (ISR)发生情况分为ISR组(n=22)与对照组 (n=104)，分析CTA对术后ISR分型诊断准 确性，并比较两组CTA定量参数差异。结 果 126例ACS患者术前经DSA确诊245支病 变冠状动脉，CTA对其狭窄程度分级诊断 准确率为87.76%(215/245)，对术后ISR分 型诊断准确率为78.57%(99/126)。术后 ISR组CT血流储备分数(FFRCT)、管腔内密 度衰减梯度-校正值(TAG-CCO)水平均明 显低于对照组，差异均有统计学意义(P ＜0.05)。结论 CTA能对ACS患者介入治疗 术前血管狭窄程度进行准确分级，并在 术后随访中对ISR作出早期定性与定量评 估，有利于制定合理介入治疗方案并改善 患者预后。

Objective To explore the clinical value of CT angiography (CTA) in patients with acute coronary syndrome (ACS) before and after interventional therapy. Methods The clinical data of 126 ACS patients undergoing interventional therapy were retrospectively analyzed. Digital subtraction angiography (DSA) was used as the gold standard to analyze the accuracy of CTA in the grading diagnosis of postoperative vascular stenosis degree in patients with ACS. According to the occurrence of in-stent restenosis (ISR) within 6 months after operation, the patients were divided into ISR group (n=22) and control group (n=104). The accuracy of CTA in the diagnosis of postoperative ISR classification was analyzed, and the CTA quantitative parameters were compared between the two groups. Results Among 126 patients with ACS, 245 coronary artery lesions were diagnosed by DSA before operation, and the accuracy of CTA for stenosis degree grading was 87.76% (215/245), and the accuracy for postoperative ISR classification was 78.57% (99/126). The CT fractional flow reserve (FFRCT) and transluminal contrast attenuation gradient-corrected contrast opacification (TAG-CCO) in ISR group after operation were significantly lower than those in control group (P<0.05). Conclusion CTA can accurately classify the vascular stenosis degree before interventional therapy for ACS patients, and make early qualitative and quantitative evaluation for ISR during postoperative followup, and it is conducive to the development of reasonable interventional therapy and the improvement of prognosis.