期刊文献+

多层螺旋CT时代冠状动脉造影人群不同治疗方案选择比例

Different therapeutic proportion of the patients undergoing coronary angiography in the era of development in multislice spiral computed tomography
下载PDF
导出
摘要 目的报道多层螺旋CT时代冠状动脉造影人群比例。方法选自2007-02~2009-07于首都医科大学大兴医院行冠状动脉造影的连续1 027例患者,其中男性642例,女性385例,平均年龄(58.31±10.01)岁。根据冠状动脉造影结果,冠状动脉狭窄<50%者不诊断冠心病,任何一支狭窄≥50%者诊断冠心病;病变狭窄≥70%,而病变及临床情况适合支架植入者,方可置入支架;冠状动脉旁路移植手术的建议依据指南推荐。结果 1 027例患者行冠状动脉造影结果显示,183例(17.82%)患者正常;844例(82.18%)患者诊断冠心病,其中273例(26.58%)不需支架置入(包括支架置入后随访性冠状动脉造影),315例(30.67%)置入支架,218例(21.23%)建议行冠状动脉旁路移植术,38例(3.7%)行支架置入未成功或适合介入治疗但因其他原因未进行治疗者。结论多层螺旋CT有助于避免诊断性冠状动脉造影,提高造影患者的阳性率。 Objective To evaluate the different therapeutic proportion of the patients undergoing coronary angiography(CAG)in the era of development in multislice spiral computed tomography(MSCT).Methods A total of 1 027 consecutive patients,who underwent CAG in Daxing Hospital from February 2007 to July 2009,were enrolled,642 males and 385 females.The patients were not diagnosed to have coronary heart disease(CHD) with less than 50% diameter stenosis of coronary artery by coronary angiogram,but the patients to have CHD with more than or equal to 50% stenosis of coronary artery.The patients with more than or equal to 70% stenosis could be performed the percutaneous coronary intervention(PCI),and the decision-making for PCI is mainly based on the clinical demonstration and the coronary lesion morphology,which was suitable for PCI.The patients were proposed to have coronary aortic bypass graft(CABG) surgery based on the guideline.Results Of 1 027 consecutive patients,183 patients(17.82%)had not been diagnosed to have CHD,and 844(82.18%)to have CHD.Of these patients with CHD,273 patients(26.58%)were not indicated for PCI(including the patients receiving follow-up coronary angiography after stenting),315(30.67%)had been performed the stent implantation,218(21.23%)were proposed to have CABG,38(3.7%)failed in the procedure of PCI or had not been performed because of opposing to this therapy.Conclusion MSCT can be applied as a non-invasive screening tool to avoid coronary angiography for the diagnosis of CHD,and to increase the positive proportion of the patients with CHD after receiving coronary angiograhpy.
出处 《山西医科大学学报》 CAS 2011年第8期650-652,共3页 Journal of Shanxi Medical University
基金 北京市卫生系统高层次卫生技术人才培养项目资助(2009-3-68) 首都医学发展科研基金(2009-3261)
关键词 冠心病 多层螺旋CT 冠状动脉造影 coronary heart disease multislice spiral computed tomography coronary angiography
  • 相关文献

参考文献9

  • 1Ethevenot G, Westphal JC, Massin N, et al. Normal coronary angiography. Have the indications changed during the 1980 ' s [ J ] ? Arch Mal Coeur Vaiss, 1997,90 (7) :905 - 910.
  • 2Gilard M, Le Gal G, Cornily JC, et al. Midterm prognosis of patients with suspected coronary artery disease and normal muhislice com- puted tomographic findings: a prospective management outcome study [ J ]. Arch Intern Med,2007,167 ( 15 ) : 1686 - 1689.
  • 3Sato Y, Matsumoto N, Kato M, et al. Noninvasive assessment of cor- onary artery disease by multislice spiral computed tomography u- sing a new retrospectively ECG-gated image reconstruction tech- nique-Comparison with angiographic results [ J ]. Circ J, 2003,67 (5) :401 -405.
  • 4King SB, Smith SC Jr, Hirshfeld JW, et al. 2007 Focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coro- nary intervention [ J ]. J Am Coll C ardiol,2008,51:172 -209.
  • 5殷宝玲,张镭,缪国斌,马展鸿,范慊,张辉,张丽,陆致玲,张麟.64层CT与冠状动脉造影在老年冠心病诊断中的对比研究[J].中华老年心脑血管病杂志,2007,9(2):92-95. 被引量:10
  • 6Cademartiri F,Maffei E,Palumbo A,et al. Diagnostic accuracy of 64-slice computed tomography coronary angiography in patients with low-to-intermediate risk [ J ]. Radiol Med, 2007, 112 ( 7 ) : 969 - 981.
  • 7Leschka S, Alkadhi H, Plass A, et al. Accuracy of MSCT coronary angiography with 64-slice technology: first experience [ J ]. Eur Heart J,2005,26( 15 ) : 1482 - 1487.
  • 8Raff GL, Gallagher MJ, O'Neill WW, et al. Diagnostic accuracy of noninvasive coronary angiography using 64-slice spiral computed tomography [ J ]. J Am Coll Cardiol,2005,46 ( 3 ) : 552 - 557.
  • 9Martuscelli E, Romagnoli A, D' Eliseo A, et al. Accuracy of thin- slice computed tomography in the detection of coronary stenoses [ J]. Eur Heart J ,2004,25 ( 12 ) : 1043 - 1048.

二级参考文献11

  • 1Ethevenot G,Westphal JC,Massin N,et al.Normal coronary angiography.Have the indications changed during the 1980's[J] ? Arch Mal Coeur Vaiss,1997,90:905-910.
  • 2Hovland A,Jonland K,Wiseth R.Coronary angiography in octogenarians[J].Tidsskr Nor Laegeforen,2003,123:1668-1670.
  • 3Elbaz M,Fourcade J,Carrie D,et al.Coronary artery disease in octogenarians:contribution of coronary angiography and evaluation of therapeutic possibilities[J].Arch Mal Coeur Vaiss,1995,88:1391 -1398.
  • 4Vrtiska TJ,Fletcher JG.McCollough CH.State-of-the-art imaging with 64-channel multidetector CT angiography[J].Perspect Vasc Surg Endovasc Ther,2005,17:3-10.
  • 5Anders K,Baum U,Lell M,et al.Diagnostic imaging with a 64-slice computed tomography scanner-the first year in clinical[J].Rontgenpraxis,2005,55:229-233.
  • 6FlohrT,Stierstorfer K,Raupach R,et al.Performance evaluation of a 64-sliceCT system with z-flying focal spot[J].Rofo,2004,176:1803-1810.
  • 7Nikolau K,Flohr T,Knez A,et al.Advances in cardiac CT imaging:64-slice scanner[J].Int J Cardiovasc Imaging,2004,20:535-540.
  • 8American College of Cardiology/Society for cardiac Angiography and Interventions Clinical expert consensus document on Cardiac Catheterization Laboratory standards[J].J Am Coll Cardiol,2001,37:2170-2214.
  • 9Knez A,Becker C,Becker A,et al.Technique and possibilities of cardiac computed tomography[J].MMW Fortschr Med,2004,146:31 -44.
  • 10Leschka S,Alkadhi H,Plass A,et al.Accuracy of MSCT coronary angiography with 64-slice technology:first experience[J].Eur Heart J,2005,26:1482-1487.

共引文献9

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部