64排螺旋CT诊断不同程度冠状动脉狭窄的临床价值

储敏峰

[摘要] 目的 探析64排螺旋CT诊断不同程度冠状动脉狭窄的临床价值。 方法 整群选取该院2013年7月—2015年11月收治的604例疑似为冠状动脉狭窄病变的患者，均给予患者64排螺旋CT冠脉成像（CTA）诊断和常规的冠脉造影（CAG）诊断，比较分析狭窄及闭塞的情况。结果 CTA对冠脉血管狭窄的诊断，126例通畅，160例轻度狭窄，155例中度狭窄，87例重度狭窄，76例闭塞与CAG比较差异无统计学意义（P>0.05）。CTA诊断后，轻度狭窄的敏感度71.85%、特异性96.85%、准确率95.70%；中度狭窄的敏感度73.84%、特异性97.85%、准确率91.56%；重度狭窄的敏感度87.42%、特异性96.85%、准确率89.57%。 结论 CTA诊断不同程度冠状动脉狭窄的价值高，准确率高，具有一定的临床特征，是理想的检查方式，值得推广。

[关键词] 64排螺旋CT；不同程度；冠状动脉狭窄；临床价值

[中图分类号] R816 [文献标识码] A [文章编号] 1674-0742（2017）02（b）-0164-03

[Abstract] Objective To analyze the clinical value of 64-slice spiral CT in diagnosis of different degrees of coronary stenosis. Methods 604 cases of patients suspected with coronary stenosis admitted and treated in our hospital from July 2013 to November 2015 were group selected and were diagnosed with the CTA and CAG， and the stenosis and obstruction were compared and analyzed. Results The CTA diagnosis showed that there were 126 unobstructed cases， 160 cases with mild stenosis， 155 cases with medium stenosis and 87 cases with severe stenosis and 76 with obstruction and the difference between the CTA and CAG had no statistical significance by comparison（P>0.05）， and after the CTA diagnosis， and the sensitivity， specificity and accuracy of mild stenosis were respectively 71.85%， 96.85% and 95.70%， and of the medium stenosis were respectively 73.84%， 97.85% and 91.56% and of the severe stenosis were respectively 87.42%， 96.85% and 89.57%. Conclusion The value and accuracy of CTA in diagnosis of different degrees of coronary stenosis are high with a certain clinical features， and it is an ideal examination method and is worth promotion.

[Key words] 64-slice spiral CT； Different degrees； Coronary stenosis； Clinical value

冠脈狭窄是指患者的冠状动脉功能由于受到了损害，进而出现了心肌缺血缺氧的症状，导致管腔发生狭窄或者冠脉血管壁被粘稠的硬化物堵塞，最终出现闭塞的情况[1]。相关研究显示[2]，冠脉粥样硬化导致其斑块发生破裂及狭窄是引起患者冠心病的主要因素。临床上比较常见的诊断方式为冠脉造影，也是金标准，近年来，CT技术广泛应用于临床中，为探析64排螺旋CT诊断不同程度冠状动脉狭窄的临床价值，该文将2013年7月—2015年11月收治的604例疑似为冠状动脉狭窄病变的患者，作为研究对象，现报道如下。

1 资料与方法

1.1 一般资料

整群选取该院收治的604例疑似为冠状动脉狭窄病变的患者，男性353例，女性251例，年龄24～86岁，平均（55.2±6.9）岁，伴糖尿病者126例，伴高血脂者75例，高血压者170例，心绞痛者175例，遗传性心血管疾病70例，心肌梗死70例。