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目的探索64层CT冠状动脉造影和左心功能分析进行冠心病急性心肌梗塞风险预测的作用和价值。方法对289例64层CT冠状动脉造影和左心功能资料进行回顾性分析。按照冠状动脉管腔狭窄程度以及斑块的种类将受检者分为4组:Ⅰ,管壁光整或呈环形增厚,管腔狭窄<30%;Ⅱ,管壁偏心性增厚或单发钙化斑块,管腔狭窄<50%;Ⅲ,单或多发软斑块,管腔狭窄<50%;Ⅳ,多发软斑块或多发混合性斑块,管腔狭窄>50%。按组别分别计算左心室功能指标的平均值,进行统计学分析并与临床资料对照。结果LVMM,LVEDV与临床证实的心肌缺血发生率间呈正相关(r≈0.82,0.76)。LVEF与临床证实的心肌缺血发生率间呈负相关(r≈-0.74)。结论仅依据冠状动脉狭窄程度无法准确预测冠心病急性心肌梗塞风险。运用64层CT冠状动脉造影和左心功能分析能够同时显示冠状动脉的狭窄程度和斑块类型以及心脏功能改变,在冠心病急性心肌梗塞风险预测中具有更大意义。
Objective To explore the role and value of 64-slice CT coronary angiography and left ventricular function in predicting the risk of acute myocardial infarction in patients with coronary heart disease. Methods 289 cases of 64-slice CT coronary angiography and left ventricular function data were retrospectively analyzed. According to the extent of coronary stenosis and the type of plaque, the subjects were divided into 4 groups: Ⅰ, the wall smoothing or annular thickening, stenosis <30%; Ⅱ, thickening of the wall eccentricity or single Hair calcification plaque, stenosis <50%; Ⅲ, single or multiple soft plaque, stenosis <50%; Ⅳ, multiple soft plaque or multiple mixed plaque, stenosis> 50%. The average values of left ventricular function were calculated respectively by group and statistically analyzed and compared with clinical data. Results There was a positive correlation between LVMM, LVEDV and clinically confirmed myocardial ischemia (r ≈ 0.82,0.76). There was a negative correlation between LVEF and the clinically confirmed incidence of myocardial ischemia (r≈-0.74). Conclusion According to the degree of coronary artery stenosis, the risk of acute myocardial infarction in coronary heart disease can not be accurately predicted. Using 64-slice CT coronary angiography and left ventricular function analysis can simultaneously show the degree of coronary stenosis and plaque type and cardiac function changes in coronary heart disease with acute myocardial infarction risk prediction has more significance.