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目的初步评估不同狭窄程度左前降支腔内强化梯度与相应冠状动脉供血区心肌首过灌注表现及其相关性。方法搜集CT冠状动脉成像诊断前降支狭窄病例52例(狭窄<50%组及狭窄≥50%组)与无狭窄病例20例(对照组),分别测量并计算前降支供血区心肌首过灌注值及其校正值、前降支腔内强化梯度及其校正值,进行统计学分析。结果 (1)狭窄组和对照组在收缩期、舒张期前降支腔内强化梯度校正值及供血区心肌首过灌注值差异均无统计学意义(均P>0.05);而首过灌注校正值差异均有统计学意义(均P<0.05)。(2)狭窄<50%组、狭窄≥50%组和对照组三组间在收缩期、舒张期前降支腔内强化梯度校正值及供血区心肌首过灌注值差异均无统计学意义(均P>0.05)。(3)狭窄<50%组和对照组在收缩期心肌首过灌注校正值差异无统计学意义(P>0.05),在舒张期差异有统计学意义(P<0.05);狭窄≥50%组与狭窄<50%组、狭窄≥50%组与对照组在收缩期、舒张期心肌首过灌注校正值差异分别具有统计学意义(均P<0.05)。结论心肌首过灌注校正值更能客观反映相应冠状动脉供血区的心肌血流灌注情况;腔内强化梯度校正值不能有效预测心肌缺血。
Objective To evaluate the correlation between the initial gradient of left anterior descending coronary artery in different degree of stenosis and the first perfusion of myocardium in the corresponding coronary artery blood supply. Methods CT angiography was used to diagnose the anterior descending coronary artery stenosis in 52 cases (50% stenosis group and 50% stenosis group) and 20 cases without stenosis group (control group) Perfusion value and its correction value, anterior descending intraluminal enhancement gradient and its correction value, for statistical analysis. Results (1) There was no significant difference between the stenosis group and the control group in systolic and diastolic anterior descending intrathoracic enhanced gradient correction and the first perfusion of myocardial infarction (all P> 0.05) Value differences were statistically significant (all P <0.05). (2) There was no significant difference in systolic, diastolic anterior descending intrathoracic enhanced gradient correction and the first myocardial perfusion in the stenosis group <50%, stenosis≥50% group and the control group All P> 0.05). (3) There was no significant difference in the corrected value of myocardial perfusion between systolic and diastolic diameters in the group of <50% and the control group (P> 0.05), but there was a significant difference in the diastolic phase (P <0.05) Compared with the control group, the difference of myocardial perfusion between systolic and diastolic myocardial perfusion was statistically significant (P <0.05). Conclusions The myocardial perfusion correction value can objectively reflect the myocardial perfusion in the coronary artery blood supply area. Intraluminal intensified gradient correction can not effectively predict myocardial ischemia.