冠状动脉CTA在有无症状心肌缺血患者冠脉的对比研究

A comparative study of coronary artery CTA in patients with symptomatic myocardial ischemia

目的对比与分析有无症状心肌缺血患者的冠状动脉CTA检查结果。方法特选取2015年6月~2017年6月本院收治的84例冠心病患者为研究对象,经12导联心电图或动态心电图检查,表现为典型缺血性ST-T改变,并明确诊断为心肌缺血,按有无症状心肌缺血进行分组,45例无症状心肌缺血患者设为观察组,39例有症状心肌缺血患者设为对照组,两组患者均行冠状动脉CT血管造影(CTA)检查,对比两组患者出现动脉狭窄的发生率、狭窄程度及斑块出现的情况。结果观察组患者动脉狭窄发生率与对照组相比,差异无统计学意义;患者在动脉狭窄方面,观察组患者主要以Ⅰ级动脉狭窄多发,对照组患者主要以动脉狭窄Ⅱ级以上者多发,二者相比差异具有统计学意义(P<0.05)。观察组患者斑块、软斑块发生率明显低于对照组;而钙化性斑块发生率明显高于对照组,差异具有统计学意义(P<0.05)。结论经CTA检查结果显示,有无症状心肌缺血患者的动脉狭窄发生率无明显差异,但无症状心肌缺血患者冠状动脉狭窄程度、斑块数量及软斑块发生率均要高于有症状心肌缺血患者。

Objective To compare and analyze the results of CTA examination in patients with symptomatic myocardial ischemia.Methods Selection,in June2015-June2017of our hospital,84cases of coronary heart disease patients as the research object,from the12-lead electrocardiogram or dynamic electrocardiogram inspection,show the typical ischemic ST-t change,and a clear diagnosis of myocardial ischemia,myocardial ischemia are grouped according to the presence of symptoms,45patients with asymptomatic myocardial ischemia were set as observation group,39patients with symptomatic myocardial ischemia were set as control group,two groups of patients were performed coronary artery CT angiography(CTA),and compared the incidence rate of two groups of patients with artery stenosis,degree of stenosis and plaque scenario.Results The patients in the observation group were arterial stenosis rate compared with the control group,the difference was not statistically significant;in patients with artery stenosis,the patients in the observation group were mainly grade multiple artery stenosis,control group patients with major artery stenosis grade were two,compared to the difference was statistically significant(P<0.05).The incidence of plaque and soft plaque in the observation group was significantly lower than that in the control group,while the incidence of calcified plaque was significantly higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion The CTA showed that there are no symptoms of myocardial ischemia in patients with arterial stenosis rate had no significant difference,but no degree of coronary artery stenosis and myocardial ischemia symptoms the number of plaques were higher than the incidence of soft plaque symptoms in patients with myocardial ischemia.