【摘要】 目的 探讨64排螺旋CT冠状动脉成像(CTA)在冠状动脉无保护左主干病变(UPLM)介入治疗中的应用价值。方法随机选取25例2012年1月至2014年1月在粤北人民医院心血管内科临床诊断为冠心病,并进行经导管冠脉造影(12AG),确诊为UPLM的患者。其中12例患者术前进行了CTA检查;13例患者术前未进行CTA检查,而直接进行CAG及PCI。结果 12例介入诊疗前进行CTA检查的患者,CTA检查阳性预测值为100%,介入治疗均成功,手术成功率100%,术中未出现低血压及慢血流等并发症情况,PCI平均操作时间(30±5)min。13例术前未进行CTA检查的患者,有11例选择行PCI并成功,PCI成功率100%o但其中有6例患者在CAG及PCI术中出现低血压(46%),2例患者术中出现冠脉慢血流(15%),整体并发症发生率为61%,与CTA组比较差异有统计学意义(P<0.01);PCI平均操作时间(50±9)min,较CTA组明显增加(P<0.01)。另外2例患者术前未行CTA检查,行CAG后放弃PCI治疗,择期行CABG(15%)。结论冠心病患者术前行CTA检查,有助于提前发现UPLM,从而提高UPLM患者介入手术成功率,减少术中并发症。更多还原

【Abstract】 Objective To explore clinical value of multi-slice computed tomography angiography(CTA)in percutaneous coronary(PCI) treatment of unprotected coronary artery left main(UPLM) disease.Methods This study included 25 patients with UPLM disease defined by coronary angiography(CAG) in our hospital during Jan.2012 to Jan.2014.12 patients performed CTA before CAG and PCI.13 patients without performed CTA before CAG and PCI.Results In the CTA group,the positive predictive values(PPV) of CTA in deteting UPLM was100%,and the success rate and complication rate in PCI were 100%,100%and 0%.Anouthe group patients,13 patients performed CAG and 11 patients undergo PCI and 2 patients undergo CABG.The success rate of the 11 patients was also 100%,but 6 patients of them with low blood pressure(46%) and 2 patients of them with slow blood flow phenomenon(15%).The overall incidence of complication was 61%(P<0.01).Mean procedure time of PCI of CTA group patients was(30±5)min.Mean procedure time of PCI of another group patients was(50±9)min(P<0.01).Conciuslon Coronary heart disease patients performed CTA before CAG and PCI will help to advance found in patients with UPLM,and increased the success rate and reduce complication rate in PCI coronary angiography coronary angiography.更多还原