摘要
目的分析CT血管成像(CTA)在冠心病(CHD)患者冠脉钙化病变定性诊断及主要不良心血管事件(MACE)预测中的应用价值。方法回顾性收集2021年6月至2023年6月至我院就诊的60例老年CHD患者的临床资料,根据随访结果将其划分为MACE组(21例)和非MACE组(39例)。所有患者均接受CTA检查,收集所有患者基线资料、CTA检查结果,分析CTA参数对冠脉钙化病变的定性诊断价值和对MACE的预测价值。结果60例CHD患者共检出73处斑块,其中脂质斑块31处,纤维斑块23处,钙化斑块19处。不同性质冠状动脉斑块CT值存在显著差异,钙化斑块>纤维斑块>脂质斑块(P均<0.05)。MACE组冠脉CT血流储备分数(FFRCT)小于非MACE组(P<0.05),MACE组冠脉狭窄程度大于非MACE组(P<0.05)。logistic回归分析结果显示,FFRCT、冠脉狭窄程度为导致CHD患者发生MACE的独立危险因素(P<0.05)。受试者工作特征曲线结果显示,FFRCT、冠脉狭窄程度预测MACE的曲线下面积(AUC)为0.886、0.785,二者联合AUC为0.921,显著高于单独指标(Z=8.793、4.639,均P<0.001),联合因子敏感度为100.00%,特异度为74.36%。结论CTA参数可用于CHD患者冠脉钙化病变的定性诊断,FFRCT、冠脉狭窄程度对CHD患者发生MACE具有预测价值,且联合检测可提高预测效能。
Objective To analyze the application value of CT angiography(CTA)in qualitative diagnosis of coronary artery calcification and prediction of major adverse cardiovascular events(MACE)in patients with coronary heart disease(CHD).Methods The clinical data of 60 elderly patients with CHD admitted to the hospital from June 2021 to June 2023 were retrospectively collected.According to follow-up results,the patients were divided into MACE group(21 cases)and non-MACE group(39 cases).All patients received CTA.Their baseline data and CTA results were collected.The value of CTA parameters in qualitative diagnosis of coronary artery calcification and prediction of MACE was analyzed.Results A total of 73 plaques were detected in 60 patients with CHD,including 31 lipid plaques,23 fibrous plaques,and 19 calcified plaques.CT values of different properties of coronary artery plaques were significantly different.CT values of calcified plaques,fibrous plaques,and lipid plaques decreased in sequence(all P<0.05).The coronary CT-derived fractional flow reserve(FFRCT)of MACE group was lower than that of non-MACE group(P<0.05),and coronary artery stenosis in MACE group was more severe than that in non-MACE group(P<0.05).Logistic regression analysis found that FFRCT and the degree of coronary artery stenosis were independent risk factors for MACE in patients with CHD(P<0.05).The receiver operating characteristic curve analysis showed that the areas under the curve(AUCs)of FFRCT and the degree of coronary artery stenosis for predicting MACE were 0.886 and 0.785.The AUC of combination of the two was 0.921,which was significantly greater than that of a single parameter(Z=8.793,4.639,both P<0.001).The sensitivity and specificity of joint prediction were 100.00%and 74.36%.Conclusion CTA parameters can be used for qualitative diagnosis of coronary artery calcification in patients with CHD.FFRCT and the degree of coronary artery stenosis are helpful for prediction MACE in patients with CHD,and combination of the two can improve predictive efficacy.
作者
付豪
翟亚娟
FU Hao;ZHAI Ya-juan(Department of Imaging,the Third Affiliated Hospital of Luohe Medical College,Luohe 462000,Henan Province,China)
出处
《中国CT和MRI杂志》
2025年第3期90-93,共4页
Chinese Journal of CT and MRI
关键词
CT血管成像
冠心病
定性诊断
主要心血管不良事件
CT Angiography
Coronary Heart Disease
Qualitative Diagnosis
Major Adverse Cardiovascular Event
