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目的探讨16层螺旋CT冠状动脉造影对不稳定型心绞痛患者的诊断价值。方法对60例不稳定型心绞痛的患者进行临床Braunwald分级,并行16层螺旋CT冠状动脉造影和经皮选择性冠状动脉造影术。根据16层螺旋CT显示冠状动脉狭窄程度分为二组:A组冠状动脉重度狭窄。B组冠状动脉正常、轻度狭窄或中度狭窄。结果60例UAP患者中,A组45例(占75%),B组15例(占25%)。A组中Braunwald分级,ⅢA或ⅢB者17例(占37.8%),B组中2例(占13.3%)。A组明显高于B组(P<0.05)。A组中经皮选择性冠状动脉造影提示冠状动脉重度狭窄36例(占80.0%),明显高于B组2例(占13.3%P<0.05)。16层螺旋CT冠状动脉造影对照经皮选择性冠状动脉造影提示冠状动脉重度狭窄的敏感性和特异性分别是90%和55%。结论16层螺旋CT冠状动脉造影对不稳定型心绞痛患者具有良好的诊断价值,并可对冠状动脉形态学进行良好评价,从而进行介入治疗的筛选。但并不能完全取代传统的经皮选择性冠状动脉造影术。
Objective To investigate the diagnostic value of 16-slice spiral CT coronary angiography in patients with unstable angina pectoris. Methods Sixty patients with unstable angina were treated with clinical Braunwald grading and 16-slice spiral CT coronary angiography and percutaneous selective coronary angiography. According to 16-slice spiral CT showed the degree of coronary artery stenosis divided into two groups: A group of severe coronary stenosis. Group B normal, mild or moderate stenosis. Results Among the 60 UAP patients, 45 cases (75%) in group A and 15 cases (25%) in group B. Braunwald grading in group A, 17 cases (37.8%) in group ⅢA or ⅢB, and 2 cases (13.3%) in group B. A group was significantly higher than the B group (P <0.05). A group of percutaneous coronary angiography showed severe coronary stenosis in 36 cases (80.0%), significantly higher than the B group in 2 cases (13.3% P <0.05). The sensitivity and specificity of 16-slice spiral CT coronary angiography versus percutaneous selective coronary angiography showed that coronary stenosis was 90% and 55%, respectively. Conclusion 16-slice spiral CT coronary angiography has a good diagnostic value in patients with unstable angina and can be a good evaluation of coronary artery morphology, in order to carry out interventional screening. But it can not completely replace the traditional percutaneous coronary angiography.