DSA低剂量技术在肥胖冠心病患者行PCI手术的临床效果观察

Clinical efficacy of low-dose acquisition technique of DSA in coronary heart disease with PCI operation

目的研究数字减影血管造影(DSA)低剂量技术在肥胖冠心病患者行经皮冠状动脉介入干预(PCI)手术的临床效果。方法选取2019年5月至2020年4月广东省化州市人民医院收治的90例符合行PCI手术标准的肥胖冠心病患者(BMI>30 kg/m^(2)),随机分成DSA低剂量组与常规剂量组,两组患者分别在不同的射线剂量下开展PCI手术,分别记录不同体位序列下的图像质量、射线累积剂量值(CD)及剂量面积乘积值(DAP);通过心脏超声测定术前术后心功能(LVEF、LVESD、LVEDD)的变化;采用SF-36、SAQ量表评价患者术后生活质量;测定术后血清炎症因子(hs-CRP、TNF-α、IL-6)指标值。结果DSA低剂量组与常规剂量组所获得的图像其血管的3级分支均能清晰显示、血管边缘锐利度良好、图像噪声无明显差异,均能满足临床诊治要求。而DSA低剂量组的CD值、DAP值显著低于常规剂量组(P<0.05),且SF-36健康调查表显示低剂量组较常规剂量组要优(P<0.05)。术后两组心功能表现及血液炎症因子含量接近,无统计学差异(P>0.05)。结论DSA低剂量组在满足临床诊治要求的低辐射剂量范围内,能保证肥胖冠心病患者顺利开展PCI手术,术后康复效果较好,且患者及医护人员受照辐射较少,值得临床推广使用。

Objective To study the clinical effect of low-dose digital subtraction angiography(DSA) technique in obese patients with coronary heart disease undergoing percutaneous coronary intervention(PCI)surgery.Methods From May 2019 to April 2020,90 obese patients with coronary heart disease(BMI>30 kg/m^(2))who met the criteria for PCI surgery were selected and randomly divided into DSA low-dose group and conventional-dose group.The two groups of patients underwent PCI operations under different radiation doses,and recorded the image quality,cumulative radiation dose(CD)and dose area product(DAP)under different body positions respectively;cardiac function was measured before and after the operation by echocardiography(LVEF,LVESD,LVEDD)changes;SF-36,SAQ scales were used to evaluate the postoperative quality of life of patients;postoperative serum inflammatory factors(hs-CRP,TNF-α,IL-6)index values were measured.Results The images obtained by the DSA low-dose group and the conventional dose group can clearly display the three-level branches of the blood vessels,have good blood vessel edge sharpness,and have no significant difference in image noise,which can meet the clinical diagnosis and treatment requirements.The CD value and DAP value of the DSA low-dose group were significantly lower than those of the conventional dose group(P<0.05),and the SF-36 health questionnaire showed that the low-dose group was better than the conventional dose group(P<0.05).The cardiac function performance and blood inflammatory factor content of the two groups were similar after operation,and there was no statistical difference(P>0.05).Conclusions The DSA low-dose group can ensure smooth PCI surgery for obese patients with coronary heart disease within the low radiation dose range that meets the requirements of clinical diagnosis and treatment.The postoperative rehabilitation effect is better,and patients and medical staff receive less radiation,which is worthy of clinical promotion.