CT血管成像对冠状动脉慢性闭塞病变介入治疗的应用价值

Value of coronary CTA imaging in interventional therapy of chronic coronary artery occlusion pathological changes

目的探讨CT血管成像(CT angiography,CTA)对冠状动脉慢性完全闭塞病变(chnmic total occlusion,CTO)介入治疗的应用价值。方法回顾性分析我院62例CTO患者的临床资料,将术前行CTA检查的32例作为A组;未行CTA检查30例作为B组,比较两组血管再通率、导丝未通过发生率、并发症发生率,并对A组治疗成功和失败患者的CTO病变局部平均钙化积分和手术时间进行比较。结果 A组血管再通率为73.17%,B组为42.11%,两组比较有统计学差异(P<0.05)。A组血管再通患者平均手术时间(75±30)min,B组为(105±40)min,两者比较有统计学差异(P<0.05)。A组介入治疗成功患者CTO病变局部平均CT密度值(400±72)Hu,介入治疗失败患者为(520±108)Hu,两者比较有统计学差异(P<0.01)。结论 CTA检查可提高CTO病变介入治疗成功率,并减少介入治疗时间;CTO病变平均CT密度值、血管闭塞时间和血管病变长度影响介入治疗成功率。

Objective To study the value of coronary CTA imaging in interventional therapy of chronic coronary artery occlu- sion（CTO） lesions. Methods The clinical data of 62 patients with CTO were analyzed retrospectively, 32 cases with preoperative CT examination as group A; 30 patients without CTA check as group B. Vascular recanalization rates, guide wire non-passaging rates, and incidence rates of complications in the two groups were compared. Results Blood vessel recanalization rate in group A was 73.17% , and that in group B was 42.11% , with significant difference between the two groups （P 〈 0.05）. The an average time of operation in group A with vascular recanalization was （75 ± 30） min; that in group B was （ 105 ± 40） min, with significant difference （P 〈 0.05 ）. The average density of CT in CTO lesions of group A with successful interventional treatment was （400 ± 72） Hu, whereas that in those with failing intervention treatment was （520 ± 108） Hu, with significant difference （P 〈 0.01 ）. Conclusions CTO lesions mean CT density, vascular occlusion time, and vascular lesion length influence the success rate of interventional therapy; CT examination im- proves the success rate of intcrventional therapy CTO lesions and reduces time of interventional therapy.