256排颈、冠状动脉联合CT血管造影在冠状动脉狭窄诊断中的价值

The value of 256 slice carotid artery combined with coronary CT angiography in the diagnosis of coronary artery stenosis

目的:探讨256层颈动脉联合冠状动脉CT血管造影(CTA)在冠状动脉粥样硬化诊断中的价值。方法:选取2019年1月至2020年6月在我院行256层颈动脉联合冠状动脉CTA、冠脉血管造影(CAG)检查,根据CAG检查患者115例。根据结果冠状动脉狭窄程度是否达到50%分为两组;其≥50%为观察组(75例),<50%为对照组(40例),比较两组临床资料、冠状动脉及颈动脉斑块CTA钙化积分差异。结果:观察组吸烟、高血压比例分别为68.00%和84.00%(P<0.05);观察组冠状动脉、颈动脉斑块CTA钙化积分分别为(11.87±5.11)分和(1.56±0.64)分,(P<0.05);冠状动脉斑块CTA钙化积分与颈动脉斑块CTA钙化积分呈正相关(r=0.325,P<0.05);冠状动脉联合颈动脉斑块CTA钙化积分预测冠状动脉狭窄程度≥50%的ROC曲线下面积为0.930,明显高于冠状动脉、颈动脉斑块CTA钙化积分的0.744和0.703,P<0.05,其联合诊断的灵敏性和特异性分别为84.00%和90.00%。结论:256层颈动脉联合冠状动脉CTA在冠状动脉粥样硬化诊断中有较好的应用价值,值得临床使用。

Objective:To investigate the value of 256 slice carotid artery combined with coronary CT angiography(CTA)in the diagnosis of coronary atherosclerosis.Methods:From January 2019 to June 2020,256-slice carotid artery combined with coronary CTA and coronary angiography(CAG)were performed in our hospital,and 115 patients were examined according to CAG.According to whether the degree of coronary artery stenosis reached 50%divided into two groups.The observation group(75 cases)was≥50%,and the control group(40 cases)was<50%.The differences in clinical data,CTA calcification scores of coronary artery and carotid artery plaque between the two groups were compared.Results:The proportion of smoking and hypertension in the observation group was 68.00%and 84.00%respectively,(P<0.05);The CTA calcification scores of coronary artery plaque and arteria arteriosus plaque in the observation group were(11.87±5.11)and(1.56±0.64)respectively(P<0.05);There was a positive correlation between coronary plaque CTA calcification score and carotid plaque CTA calcification score(r=0.325,P<0.05);The area under ROC curve of coronary artery combined with carotid plaque CTA calcification score predicting coronary artery stenosis≥50%was 0.930,which was significantly higher than that of coronary artery and carotid plaque CTA calcification score of 0.744 and 0.703,P<0.05,the sensitivity and specificity of combined diagnosis were 84.00%and 90.00%respectively.Conclusion:256 slice carotid artery combined with coronary CTA has good application value in the diagnosis of coronary atherosclerosis,which is worthy of clinical use.