冠状动脉易损斑块行第三代双源CT诊断的价值及相关因素

The Value of Third-generation Dual-source CT in the Diagnosis of Vulnerable Coronary Plaques and Related Factors

目的分析冠状动脉易损斑块行第三代双源CT诊断价值及影响易损斑块形成的相关因素。方法回顾性分析我院2020年5月-2021年5月收治的50例应用第三代双源CT诊断的冠心病患者临床资料,以冠状动脉造影检查(CAG)结果作为金标准,分析第三代双源CT对易损斑块的诊断检出率以及诊断效能,同时将有≥1个易损斑块的患者列为A组,其余列为B组,比较两组患者临床基本情况及各项实验室检测指标差异,对可能影响其易损斑块形成的相关因素进行多因素Logistic回归分析。结果第三代双源CT诊断的检出率为52.78%,和CAG诊断检出率比较,差异P>0.05。双源96排CT诊断灵敏度83.33%,特异度95.24%,准确性87.96%,阳性预测值96.49%,阴性预测值78.43%。两组患者性别、年龄、内皮素-1、TC、HDL、LDL-C、吸烟、饮酒、高血压情况对比,差异均P>0.05,MMP-9、hs-CRP、IL-6、TNF-α以及糖尿病情况对比,差异均P<0.05。多因素Logistic回归分析显示影响易损斑块形成的独立危险因素为MMP-9>5.342ng/L以及hs-CRP>3.611mg/L(P<0.05)。结论在冠状动脉易损斑块的临床诊断中,第三代双源CT具有良好的诊断价值及效能,影响易损斑块形成的独立危险因素为MMP-9>5.342ng/L以及hs-CRP>3.611mg/L,需提高重视。

Objective To analyze the diagnostic value of third-generation dual-source CT for vulnerable coronary plaques and the related factors affecting the formation of vulnerable plaques.Methods To retrospectively analyze the clinical data of 50 patients with coronary heart disease diagnosed by the third-generation dual-source CT who were admitted to our hospital from May 2020 to May 2021.The results of coronary angiography(CAG)were used as the gold standard to analyze the thirdgeneration The diagnostic detection rate and diagnostic efficiency of dual-source CT for vulnerable plaques.At the same time,patients with≥1 vulnerable plaques are classified as group A,and the rest are classified as group B.Compare the basic clinical conditions and various items of the two groups of patients For the difference of laboratory test indicators,multi-factor Logistic regression analysis was performed on the related factors that may affect the formation of vulnerable plaques.Results The detection rate of the third-generation dual-source CT diagnosis was 52.78%.Compared with the detection rate of CAG diagnosis,the difference was P>0.05.The diagnostic sensitivity of dual-source 96-slice CT was 83.33%,the specificity was 95.24%,the accuracy was 87.96%,the positive predictive value was 96.49%,and the negative predictive value was 78.43%.Comparison of gender,age,endothelin-1,TC,HDL,LDL-C,smoking,drinking,and hypertension between the two groups of patients,the differences were all P>0.05,MMP-9,hs-CRP,IL-6,TNF-αAs well as the comparison of diabetes,the differences were all P<0.05.Multivariate logistic regression analysis showed that the independent risk factors affecting vulnerable plaque formation were MMP-9>5.342 ng/L and hs-CRP>3.611 mg/L(P<0.05).Conclusion In the clinical diagnosis of vulnerable coronary plaques,the third-generation dual-source CT has good diagnostic value and efficiency.The independent risk factors affecting the formation of vulnerable plaques are MMP-9>5.342 ng/L and hs-CRP>3.611 mg/L,need to pay more attention.