128排256层螺旋CT血管造影术在评估非ST段抬高心肌梗死危险程度中的应用

The Application of 128 Row 256 Slice Spiral CT Angiography in Evaluating the Risk Degree of Non ST Segment Elevation Myocardial Infarction

目的:探讨128排256层螺旋计算机断层扫描(CT)血管造影术在评估非ST段抬高心肌梗死(NSTEMI)危险程度中的应用。方法:选取2017年7月至2018年2月本院NSTEMI患者152例,所有患者均给予128排256层螺旋CT血管造影术、冠脉造影(CAG)检查,分析CT血管造影术对NSTEMI冠脉狭窄及其危险程度的评估价值。结果:在检查NSTEMI无、轻度、中度、重度冠脉狭窄方面,CAG检查分别为18例、30例、62例、42例,CT血管造影术分别为19例、31例、62例、40例;以CAG为对照,CT血管造影术评估NSTEMI冠脉狭窄的敏感度、特异度、准确度分别为98.51%、94.44%、98.03%,差异无统计学意义(P>0.05);以CAG为对照,CT血管造影术评估NSTEMI轻度、中度、重度冠脉狭窄的符合率分别为为86.67%、90.32%、90.48%,Kappa值为0.765,两种检查具有良好的的相关性。结论:128排256层螺旋CT血管造影术可有效评估NSTEMI的冠脉狭窄及其危险程度,可作为一种早期评估NSTEMI病情的无创、简易、准确筛查方法,值得临床作进一步推广。

Objective： To discuss the application of 128 row 256 slice spiral computed tomography （CT） angiography in evaluating the risk degree of non ST segment elevation myocardial ilffaretion （NSTEMI）. Methods ： 152 patients with NSTEMI were selected from July 2017 to February- 2018 in our hospital, according to the random distribution, all pa- tients were examined by 128 row 256 slice spiral CT angiography and coronary- angiography （CAG）. The value of CT an- giography for evaluating NSTEMI stenosis and its risk degree was evaluated. Results： For the cheek in NSTEMI no, mild, moderate, severe coronary- artery- stenosis, In CAG examination we had 18 eases, 30 eases, 62 eases, 42 eases; In CT angiography, we had 19 eases, 31 eases, 62 eases, 40 eases. Compared with CAG, the sensitivity-, specificity, accuracy of CT angiography evaluating the NSTEMI coronary- artery- stenosis were respectively 98. 51% , 94.44% , 98.03% , the difference was not statistically significant （P 〉0.05）. Compared with CAG, the coincidence rate of CT angiography evaluating the NSTEMI mild, moderate, severe coronary- artery- stenosis were respectively 86. 67%,90.32% , 90.48% ,the Kappa value was 0. 765, two examination has a good correlation. Conclusions： 128 row 256 slice spiral CT angiography can effectively evaluate the coronary- artery- stenosis and its risk degree of NSTEMI, it can be used as a non-invasive, simple and accurate screening method for the early assessment of NSTEMI condition,it＇ s worth for further clinical promotion.