【摘要】 目的探讨16层螺旋CT冠状动脉造影对不稳定型心绞痛患者的诊断价值。方法对60例不稳定型心绞痛的患者进行临床Braunwald分级,并行16层螺旋CT冠状动脉造影和经皮选择性冠状动脉造影术。根据16层螺旋CT显示冠状动脉狭窄程度分为二组:A组冠状动脉重度狭窄。B组冠状动脉正常、轻度狭窄或中度狭窄。结果60例UAP患者中,A组45例(占75%),B组15例(占25%)。A组中Braunwald分级,ⅢA或ⅢB者17例(占37.8%),B组中2例(占13.3%)。A组明显高于B组(P<0.05)。A组中经皮选择性冠状动脉造影提示冠状动脉重度狭窄36例(占80.0%),明显高于B组2例(占13.3%P<0.05)。16层螺旋CT冠状动脉造影对照经皮选择性冠状动脉造影提示冠状动脉重度狭窄的敏感性和特异性分别是90%和55%。结论16层螺旋CT冠状动脉造影对不稳定型心绞痛患者具有良好的诊断价值,并可对冠状动脉形态学进行良好评价,从而进行介入治疗的筛选。但并不能完全取代传统的经皮选择性冠状动脉造影术。更多还原

【Abstract】 Objective To evaluate the diagnostic value of sixteen slice spiral CT in unstable angina pectoris.Methods 60 patients of unstable angina underwent Braunwald’s class and sixteen slice spiral CT coronary angiography and conventional percutaneous selective coronary angiography.Results Among 60 UAP patients,in group A,45 cases(75%),severe coronary stenosis with sixteen slice sparil CT.In group B,2 cases(13.3%)were normal coronary or slight and midrange coronary stenosis.In group A,there were 17 cases experienced Braunwald’s class Ⅲ(A and B)unstable angina(37.8%),there were only 2 case(13.3%)in group B.It is remarkable higher in group A than that of group(P<0.05).In group A,there were 36 cases(80.0%)severe coronary stenosis with conventional percutaneous coronary angiography,and higher than that of group B(2 case,13.3% P<0.05).Compared with percutaneous coronary angiography,the sensitivity of sixteen slice sparil CT in diagnosing moderate and severe coronary stenosis was 80%,and the specificness was 66.67%.Conclusion sixteen slice spiral CT coronary angiography has clinical value in unstable angina and can provide informations about coronary morphology for advanced interventional therapy.However,its diagnostic accuracy is limited and it can’t replace the conventional percutaneous coronary angiography at present.更多还原