运用128层宝石能谱CT探讨斑块性质与心绞痛类型相关性研究

Plaque character evaluated with different angina pectoris types by using gemstone spectral imaging coronary angiography

目的运用128层宝石能谱CT冠状动脉成像评估不同类型心绞痛斑块性质的差异及临床应用价值。方法收集2015年1月至2016年12月本院确诊为冠心病的住院患者200例，根据临床资料分为稳定型心绞痛组（SA）和不稳定型心绞痛组（UA），对每组患者进行冠脉CTA扫描，评估冠状动脉内粥样斑块性质与心绞痛分型的关系。结果SA组钙化斑块占63．2％，软斑块占17．4％，混合斑块占19．4％；UA组钙化斑块占37．5％，软斑块占42．3％，混合板块占20．2％。两组比较差异有统计学意义（P〈0．05）。SA组不同狭窄病变均以钙化斑块为主，SA组不同斑块性质在冠状动脉中、重度狭窄程度之间的比较差异无统计学意义（P〉0．05）。UA组软斑块主要分布在轻、中度狭窄冠状动脉，钙化斑块主要分布在重度狭窄冠状动脉。UA组不同斑块性质在冠状动脉不同狭窄程度的分布不同（P〈0．05）。结论128层螺旋CT通过准确评估冠脉斑块性质与心绞痛类型的相关性，在冠心病危险程度分级和心绞痛的分型方面具有重要的临床应用价值。

Objective To investigate the clinical values of Gemstone Spectral Imaging coronary angiography with analysis of the relationship between plaque character and angina pectoris types. Methods Two hundred cases of hospitalized patients were collected from January 2015 to December 2016 in the Department of Cardiovascular Disease, Chenzhou City First People＇s Hospital, who were diagnosed as coronary heart disease. According to the clinical data, stable angina pectoris （SA） and unstable angina pectoris （UA）, coronary CT scan was performed for each patient to evaluate the relationship between the nature of atherosclerotic plaques and the classification of angina pectoris. SPSS 19. 0 software was used for statistical analysis. Results By analyzing the correlation between SA and UA, SA calcification plaque was accounted for 63.2% , soft plaque 17.4% , mixed plaque 19.4% ; UA calcification plaque was accounted for 37.5% ; Soft plaque was accounted for 42. 3% ; and mixed plate was accounted for 20. 2%. The difference was sta- tistically significant （ P 〈 0. 05 ）. In the SA group, all of the stenotic lesions were mainly calcified plaques. There was no significant difference in the degree of severe stenosis between the different plaques in the SA group （ P 〉 0. 05 ）. In UA group, soft plaques were the main lesion of mild and moderate stenosis of coro- nary artery, and calcified plaques were the main stenosis in severe stenosis. There were significant differ- ences in the degree of coronary artery stenosis between different plaques in UA group （ P 〈 0. 05 ）. Conclu- sions The 128-slice spiral CT can accurately evaluated the relationship between the nature of coronary plaque and the type of angina pectoris, which is of great value in the early warning and angina pectoris clas- sification of high-risk patients with coronary heart disease.