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目的探讨64层螺旋CT冠状动脉成像(CTCA)对胸痛患者冠状动脉病变的临床应用价值。方法将2012年2月—2014年4月在马鞍山市人民医院行CTCA检查的105例患者按主诉分为胸痛组和非胸痛组,回顾性比较分析2组患者一般资料、冠状动脉斑块阳性病例数、斑块性质、节段数目和管腔狭窄程度的差异。结果胸痛组56例,冠状动脉斑块阳性者45例,共176节段,其中非钙化斑块77节段、钙化斑块64节段、混合斑块35节段,0级狭窄患者11例、1级狭窄33例、2级狭窄6例、3级狭窄6例;非胸痛组49例,冠状动脉斑块阳性者23例,共69节段,其中非钙化斑块44节段、钙化斑块17节段、混合斑块8节段,0级狭窄患者26例、1级狭窄18例、2级狭窄1例、3级狭窄4例。2组性别比较差异无统计学意义(χ~2=3.26,P=0.07);2组平均年龄比较差异无统计学意义(t=0.64,P=0.52);胸痛组冠状动脉斑块阳性病例数显著高于非胸痛组(χ~2=12.79,P<0.001);2组斑块性质差异有统计学意义(χ~2=8.03,P=0.02);2组冠状动脉斑块节段数目对比差异有统计学意义(Z=-3.71,P<0.001);2组管腔狭窄程度比较差异有统计学意义(Z=-3.33,P<0.001)。结论 CTCA检查显示,胸痛患者冠状动脉斑块阳性例数和节段数目、管腔狭窄程度均高于非胸痛患者,斑块性质构成也有所不同,因此CTCA对于胸痛患者冠状动脉病变具有重要的临床应用价值。
Objective To investigate the clinical value of 64-slice spiral CT coronary angiography (CTCA) in the diagnosis of coronary artery disease in patients with chest pain. Methods From February 2012 to April 2014, 105 patients who underwent CTCA in Maanshan People’s Hospital were divided into two groups according to the chief complaint: chest pain group and non-chest pain group. The general data of two groups were retrospectively analyzed, and the positive cases of coronary plaque Number, the nature of plaque, the number of segments and the degree of stenosis. Results There were 56 cases of chest pain and 45 cases of positive coronary artery plaque. There were 176 segments in total, including 77 non-calcified plaque, 64 calcified plaque, 35 mixed plaque, 11 grade 0 stenosis, Grade 1 stenosis in 33 cases, grade 2 stenosis in 6 cases, grade 3 stenosis in 6 cases; non-chest pain in 49 cases, coronary plaque positive in 23 cases, a total of 69 segments, of which 44 non-calcified plaque, calcified plaque 17 segments, 8 mixed plaques, grade 0 stenosis in 26 patients, 18 cases of grade 1 stenosis, 2 cases of stenosis in 1 case, 3 cases of stenosis in 4 cases. There was no significant difference in gender between the two groups (χ ~ 2 = 3.26, P = 0.07). There was no significant difference in mean age between the two groups (t = 0.64, P = 0.52) (Χ ~ 2 = 12.79, P <0.001). There were significant differences in the plaque quality between the two groups (χ ~ 2 = 8.03, P = 0.02). The number of coronary plaque segments The difference was statistically significant (Z = -3.71, P <0.001). There was significant difference in the degree of stenosis between the two groups (Z = -3.33, P <0.001). Conclusion CTCA examination showed that the number of coronary plaque positive cases and the number of segments and the degree of stenosis in patients with chest pain were higher than that of non-chest pain patients, and the plaque constitution was also different. Therefore, CTCA has an important clinical application in patients with chest pain Value.