64排128层CT血管造影在急性冠脉综合征中易损斑块与心肌桥-壁冠状动脉相关性研究

Correlation Between Vulnerable Plaque in Acute Coronary Syndrome of 64-row128-slice CT Angiography and Myocardial Bridge and Mural Coronary Artery

目的旨在探讨64排128层CT血管造影在急性冠脉综合征中易损斑块与心肌桥-壁冠状动脉相关性。方法选取2018年1月至2018年12月存在易损斑块的患者78例,患者均进行了CT血管造影(CTA),比较易损斑块伴M B-McA与易损斑块不伴有MB-McA发生急性冠脉综合征的患病率。以CAG结果为参照,比较CTA显示MB-McA长度、深度及狭窄程度的差异。结果 78例患者中,共50例患者发生ACS,其中易损斑块伴心肌桥-壁冠状动脉患者30例,发生率为60.00%;易损斑块无心肌桥发生ACS者20例,发生率为40.00%,低于易损斑块无心肌桥未发生ACS率(χ^(2)=4.000,P=0.046)。CTA对深在型MB长度、浅表型及深在型的诊断分别为(10.25±2.02)mm、(30.36±9.56)%、(49.69±14.85)%,与CGA检查比较差异无明显意义(P>0.05);CTA检查诊断浅表型M B长度为(6.26±1.19)mm,低于CAG检查[(4.61±1.25)mm],差异有统计学意义(P<0.001)。结论易损斑块伴MB-McA与不伴有MB-McA发生ACS率存在差异,易损斑块伴MBMcA发生ACS率高,为临床早期积极预防及治疗提供了一定依据。

Objective To investigate the correlation between vulnerable plaque in acute coronary syndrome of 64-row 128-slice CT angiography and myocardial bridge and mural coronarv artery.Methods 78 patients with vulnerable plaques were selected from January 2018 to December 2018.All patients underwent CT angiography(CTA).Prevalence of acute coronary syndrome between vulnerable plaque with MB-McA and vulnerable plaque without MB-McA was compared.The CAG results were used as a reference to compare the differences in length,depth and stenosis of MB-McA in CTA.Results In the 78 patients,50 patients had ACS,including 30 patients with vulnerable plaque combined with myocardial bridge and m u ral coronarv artery,the incidence was 60.00%,and 20 cases with vulnerable plaque without myocardial bridge had ACS,the incidence was 40.00%,which was lower than that of patients with vulnerable plaque without myocardial bridge who did not have ACS(χ^(2)=4.000,P=0.046).The diagnosis of CTA for deep-type MB length,superficial type and deep type was(10.25±2.02),(30.36±9.56),(49.69±14.85),and there was no significa nt difference in stenosis between CTA and CGA(P>0.05).The MB length of the superficial type diagnosed by CTA was(6.2611.19) mm,which was lower than that of CAG(4.61±1.25)mm.The difference was statistically significant(P<0.001).Conlusion There are difference in ACS incidence between vulnerable plaque with MB-McA and vulnerable plaque without MB-McA.Vulnerable plaque with MB-McA has a high ACS incidence,which has guiding value for ea rly active prevention and treatment.