DSA冠状动脉造影在冠状动脉病变诊断中的价值

The Diagnostic Value of DSA Coronary Angiography on CHD

目的:分析86例冠状动脉造影(CAG)的诊断结果,评价DSA—CAG对冠状动脉病变的诊断价值。方法:应用DSA选择性CAG证实病变≥50%直径狭窄病例63例,依病变狭窄程度累及冠状动脉部位、数目、形态、冠状动脉优势状况、侧支循环及心肌梗死病例、左室壁运动情况和射血分数(EF)等进行统计分析。结果:50%狭窄或闭塞63例(73%)冠状动脉右优势型41例(66%),左优势型7例(11%)均衡型12例(20%),单支病变22例(36%)双支病变17例(27%),3支病变20例(32%)受累血管104支136处,重度狭窄及闭塞28处(45%),12例(19%)有不同程度侧支循环形成,32例做了左心室造影射血分数(LVEF)及室壁运动缩率分析,EF≥50%的20例(66%),EF40%～50%的7例(22%),<40%2例(7%),经统计学分析,严重冠状动脉狭窄与闭塞合并室壁瘤者与单纯狭窄病变LVEF差异有极显著意义(P<0.01)。结论:冠状动脉循环与分布多数为右优势型,冠状动脉病变多累及前降支(LAD),其次为右冠状动脉(RCA)及左回旋支(LCF),病变程度多为严重狭窄,侧支循环形成良好者对左心室功能有保护作用,高质量的DSA设备是开展冠心病介入的重要基础,DSA-CAG对冠状脉病变的诊断有重要价值。

Objective:Analysis 86-patients with coronary heart disease underwent CAG. To evaluate diagnostic value of DSA coronary angiography on coronary heart disease. Methods:All 86 cases 63 of them coronary artery stenosis ≥50%shown by DSA were selectively analyzed statistical analyses were involved in the degree location amount and shape of the stenosis. the distribution and collateral circulation of coronary artery ,the left ventricular wall motion and eject`fraction (EF ). Results:In 63 cases of coronary artery stenosis ≥50% occlusion ,there were 41.7 and 12 cases with right ,left and balanced dominant artery distribution ,respectively ;22,17and 20 cases with single-vessel ,double-vessel and triple-vessel lesions ,respectively there were total 136 lesions in 104 vessel ,where 28-lesions (45%)were serious narrowing or occlusion 12-patients (19%)had varied collateral circulation formation .both left ventricular ejection fraction (LVEF)and wall motion analyses in 32-patients showed 20 cases with EF ≥50%,7-with EF40%―50%and 2-with EF <40%.there was a significant difference between LVEF of serious stenoses or occlusion complicated with ventricular aneurysm and that of simple stenoses (p<0.01). Conclusion:Most coronary distributions are right dominant in this sereies coronary heart disease mostly involves LAD ,then RCA and LCF ,and also the degree of stenosis is mostly serious .moreover ,the formation of collateral circulation is helpful for protection of the function of the ventricle .Additionally the hight quality DSA equipment plays an important role in the interventional treatment of coronary artery disease .