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目的利用多层螺旋CT评价急性冠状动脉综合征(ACS)及稳定性心绞痛(SAP)患者冠状动脉病变的差异。方法连续性入选诊断为ACS及SAP、并于介入治疗前72h内行多层螺旋CT检查的患者45例,将诊断为ACS的31例作为ACS组,诊断为SAP的14例作为SAP组,将ACS组的病变分为罪犯病变和非罪犯病变,SAP组的病变定义为稳定病变;比较冠状动脉病变性质。结果 2组共有60处病变,ACS组40处,SAP组20处;ACS组罪犯病变非钙化斑块和脂质斑块比例明显高于同组非罪犯病变及SAP组的稳定病变(96.8%vs 55.6%vs 20.0%,83.3%vs 40.0%vs 25.0%,P<0.01);ACS组罪犯病变的血管截面积、斑块面积、重构指数、斑块的偏心指数明显高于同组的非罪犯病变及SAP组的稳定病变(P<0.05)。结论多层螺旋CT作为无创的影像学工具,可识别ACS与SAP患者冠状动脉斑块病变的差异。
Objective To evaluate the difference of coronary artery lesions in patients with acute coronary syndrome (ACS) and stable angina (SAP) by multislice spiral CT. METHODS: Forty-five consecutive patients who underwent multi-slice spiral CT were enrolled in the study. ACS patients were diagnosed as ACS group, 14 cases diagnosed as SAP group as SAP group, ACS group Group lesions were divided into criminals and non-criminals lesions, SAP group of lesions defined as stable lesions; coronary lesions compared. Results There were 60 lesions in two groups, 40 in ACS group and 20 in SAP group. The proportion of non-calcified plaque and lipid plaque in culprit lesion in ACS group was significantly higher than that in non-crippled lesion and SAP group (96.8% vs 55.6% vs 20.0%, 83.3% vs 40.0% vs 25.0%, P <0.01). The vascular cross-sectional area, plaque area, remodeling index and plaque eccentricity index of criminals in ACS group were significantly higher than those in non-criminals Lesions and stable lesions in SAP group (P <0.05). Conclusions Multi-slice spiral CT as a non-invasive imaging tool can identify the difference of coronary plaque lesions between ACS and SAP patients.