电子束CT在疑诊冠心病胸痛鉴别诊断中的意义

Usefulness of electron beam computed tomography scanning for dignosing of angina pectoris

目的 探讨电子束CT(EBCT)在疑诊冠心病胸痛鉴别诊断中的作用。方法 对 86例以胸痛为主要症状、临床疑诊为冠心病心绞痛者做EBCT检查冠状动脉钙化、冠状动脉造影、平板运动试验和 2 4小时动态心电图检查。结果 冠状动脉造影狭窄组冠脉钙化总积分明显高于无狭窄组 (P <0 0 5 ) ;X综合征患者冠状动脉亦存在不同程度钙化 ,但低于冠状动脉狭窄者 ;冠状动脉无钙化者心绞痛症状不典型 ,平板运动试验阴性 ,冠脉造影正常。结论 结果提示EBCT在冠心病心绞痛的诊断中有较大的意义 ,即无钙化者有可能排除冠心病心绞痛的诊断。

Objective To investigate the usefulness of electron beam computed tomography (EBCT) scanning for diagnosing Angina Pectoris. Methods EBCT , Holter ECG, treadmill test and coronary angiography were performed in 86 patients with suspected angina pectoris of coronary artery disease. Results The scores of coronary artery calcification (SCAC) in patients with coronary stenosis were much higher then those in patients without coronary stenosis ( P<0.05 ). SCAC was identified in patients with Syndrom X. However, the scores of SCAC were less than those in patients with coronary stenosis ( P<0.05 ). There were atypical symptoms, negative treadmill test and normal coronary angiography in patients without SCAC. Conclusion The results suggested that EBCT is useful for diagnosing coronary artery disease. The patients without SCAC maybe not suffer from coronary artery disease.