| 冠状动脉CT血管造影定量分析预测冠心病患者心血管事件风险的价值 |
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| 引用本文： | 刘帅,林闽江,许亚飞. 冠状动脉CT血管造影定量分析预测冠心病患者心血管事件风险的价值[J]. 中华全科医学, 2019, 17(8): 1320-1322,1407. DOI: 10.16766/j.cnki.issn.1674-4152.000933 |
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| 作者姓名： | 刘帅 林闽江 许亚飞 |
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| 作者单位： | 宁波市李惠利东部医院影像科, 浙江 宁波 315000 |
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| 基金项目： | 浙江省医药卫生科技计划项目(2019KY611) |
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| 摘 要： | 目的探究冠状动脉CT血管造影(CTA)定量指标对冠心病患者主要心血管不良事件(MACE)的预测价值。方法选取宁波市李惠利东部医院2016年9月-2017年11月诊断及治疗的冠心病患者251例并进行1年随访,根据是否发生MACE分为观察组与对照组,比较2组诊断时冠状动脉CTA指标,包括:斑块总体积(TPV)、钙化/非钙化斑块体积(CPV/NCPV)、病变长度、斑块负荷及餐巾环标志,应用Cox回归分析MACE的独立危险因素,应用ROC曲线评估CTA定量指标对MACE的预测效能。结果本研究中共有47例(19.67%)患者发生MACE;2组TPV、CPV、NCPV、病变长度、斑块负荷及餐巾环标志差异均有统计学意义(均P<0.05);TPV及斑块负荷是MACE发生的独立危险因素(OR=1.137,P<0.001;OR=1.075,P=0.002);单独应用TPV及斑块负荷预测MACE发生的AUC面积为0.764、0.796,两者联合预测的AUC为0.860,显著优于单独预测(Z=3.376,P=0.001;Z=2.707,P=0.007),且两者联合的敏感性显著优于单独预测(均P<0.05)。结论冠状动脉CTA中TPV与斑块负荷对冠心病患者MACE的发生具有较好的预测价值。
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| 关 键 词： | 冠状动脉CT血管造影 冠心病 主要心血管不良事件 预测 |
| 收稿时间： | 2019-02-20 |
The predictive value of coronary artery CTA quantitative indexes on long-term cardiovascular events in patients with coronary heart disease |
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| LIU Shuai,LIN Min-jiang,XU Ya-fei. The predictive value of coronary artery CTA quantitative indexes on long-term cardiovascular events in patients with coronary heart disease[J]. Applied Journal Of General Practice, 2019, 17(8): 1320-1322,1407. DOI: 10.16766/j.cnki.issn.1674-4152.000933 |
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| Authors: | LIU Shuai LIN Min-jiang XU Ya-fei |
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| Affiliation: | Department of Radiology, Li Huili Eastern Hospital, Ningbo, Zhejiang 315000, China |
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| Abstract: | Objective To investigate the value of computed tomography (CTA) quantitative indexes in predicting major adverse cardiovascular events (MACE) in patients with coronary heart disease. Methods From September 2016 to November 2017, 251 patients with coronary heart disease diagnosed and treated in our hospital were selected and followed up for 1 years, they were divided into observation group and control group according to whether MACE occurred, Coronary CTA indexes of the two groups were compared, including the total plaque volume (TPV), calcified and non-calcified plaque volume (CPV/NCPV), lesion length, plaque burden and napkin-ring sign. Cox regression was used to analyze the independent risk factors of MACE, and ROC curve was used to evaluate the diagnostic efficacy of CTA quantitative indicators on MACE. Results In this study, 47 patients (19.67%) developed MACE. There were significant differences in TPV, CPV, NCPV, lesion length, plaque burden and napkin-ring sign between the two groups (all P＜0.05). TPV and plaque burden were independent risk factors for MACE (OR=1.137，P＜0.001；OR=1.075，P=0.002). ROC curve showed the AUC areas single diagnosed of TPV and plaque burden in MACE were 0.764, 0.796, the combined diagnosis was 0.860, diagnostic efficacy and sensitivity were significantly better than single one (all P＜0.05). Conclusion TPV and plaque burden in coronary artery CTA have good predictive value for the occurrence of MACE in patients with coronary heart disease. |
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| Keywords: | Coronary computed tomography angioplasty Coronary heart disease Major adverse coronary events Prediction |
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