冠状动脉CT造影的无创血流储备分数(FFR_(CT))在冠心病诊治中的研究进展

<正>目前临床上诊断冠心病最常用和最重要的方法是无创冠状动脉CT造影(coronary computed tomography angiography,CCTA)和有创的冠状动脉造影(invasive coronary angiography,ICA)。但二者仅能提供冠状动脉病变的解剖学信息,不能进行功能学评价。而临床上对冠状动脉病变的功能学评估(冠状动脉狭窄是否导致心肌缺血)决定了病变(特别是临界病     

基于无创冠状动脉CT造影的血流储备分数在冠心病诊治中的研究进展

<正>冠心病目前是人们关注度最高的心血管疾病。临床上影像学诊断冠心病最常用的方法有两种:无创冠状动脉CT造影(coronary computed tomography angiography,CCTA)和有创冠状动脉造影(invasive coronary angiography,ICA)。然而,这两种方法仅可以从解剖学角度评价冠状动脉是否狭窄及判断狭窄的程度,并不能从血流灌注情况评价冠状动脉病变     

CT血流储备分数对冠心病诊疗的指导价值

有创冠状动脉造影(invasive coronary angiography,ICA)是评价冠状动脉疾病(coronary artery disease,CAD)的重要标准.介入医生通过ICA对冠状动脉狭窄的严重程度进行目测评估,决定是否采取血运重建治疗措施.然而,目测的狭窄严重程度与下游心肌缺血情况相关性较差,仅根据...     

冠状动脉CT造影的深度学习对冠心病的诊断价值

目的:评价人工智能(AI)在冠状动脉CT血管造影(CCTA)对冠心病的诊断价值.方法:对2020年6月至12月,先后行CCTA和有创冠状动脉造影(ICA)的150例患者进行回顾性分析.100例患者的CCTA图像作为训练数据集,使用卷积神经网络(CNN)进行训练,识别斑块类型和冠状动脉狭窄程度.另外50例CAD患者作为测...     

基于冠状动脉计算机断层扫描血管造影的血流储备分数对冠心病的诊断价值

目的 探讨基于冠状动脉计算机断层扫描血管造影(coronary computed tomography angiography,CCTA)的血流储备分数(coronary computed tomography angiography-derived fractional flow reserve,CT-FFR)对冠状...     

平板运动试验与冠状动脉CT血管造影对冠心病的诊断价值

目的 研究平板运动试验(treadmill exercise test,TET)与冠状动脉CT血管造影(co-ronary computed tomographic angiography,CCTA)对冠心病的诊断价值.方法 选取我院118例可疑冠心病患者作为研究对象,1个月内均在我院行TET、CCTA和冠状动脉造影(coronary arteriography,CAG)检查.以CAG结果作为诊断金标准,对TET和CCTA的检查结果进行分析.结果 TET对重度狭窄病变的检出率明显高于中度狭窄者(P<0.05);对单支、多支病变检出率比较,差异无统计学意义(P>0.05).CCTA对冠状动脉狭窄程度及单支、多支病变的检出率比较,差异无统计学意义(P>0.05).TET诊断冠心病的敏感性为81.3％,特异性为81.4％;CCTA诊断冠心病的敏感性为90.7％,特异性为79.1％;两者联合诊断冠心病的敏感性为96.0％,特异性为72.1％.结论 TET和CCTA诊断冠心病均有较高的敏感性和特异性,可作为可疑冠心病患者的常规检查.两者联合检查有助于提高诊断的敏感性,避免漏诊.     

冠状动脉CT血管造影的临床应用

在冠状动脉无创成像技术中,冠状动脉CT血管造影（cornary CT angiography,CCTA）已广泛应用于临床.CCTA通过血管注入对比剂,行多层螺旋CT心血管造影,再通过后处理达到清晰显示冠状动脉血管细节的目的,具有无创和操作简便的特点,对于血管变异、血管疾病以及显示病变和血管关系有重要价值,对冠状动脉狭窄诊断准确性高.本文回顾近年国内外的一些临床研究,综述了CCTA诊断性检查在临床中的应用.     

女性冠心病患者冠状动脉造影结果与危险因素关系探讨

冠状动脉造影(coronary angiography,CAG)在诊断冠状动脉粥样硬化性心脏病(coronary heart disease,CHD)时比心电图、活动平板试验的诊断正确率高,尤其对不典型症状较多的女性其意义更大.     

无创CT血流储备分数的研究进展

冠状动脉CT血管造影(CCTA)是目前常用的冠心病无创诊断方法,但有一定的假阳性率,导致不必要的有创冠状动脉造影。CT血流储备分数(CT-FFR)是通过对CCTA图像的进一步处理和计算对缺血做出功能性诊断,多项研究已证实了其诊断稳定型冠心病的准确性及临床可行性和安全性,但也有一些不足和限制。     

冠状动脉慢性完全闭塞病变计算机断层扫描血管成像的形态学特征

目的分析冠状动脉慢性完全闭塞病变(chronic total occlusion,CTO)在双源计算机断层扫描(computed tomography,CT)血管成像上的形态学特点,并评估具有指导经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗价值的形态学特征。方法回顾性分析经冠状动脉造影(coronary angiography,CAG)证实为CTO病变患者的术前冠状动脉CT血管成像(coronary computed tomography angiography,CCTA)影像资料。评估并记录CCTA上所显示的各形态学指标,包括病变位置、闭塞血管长度、闭塞段血管近端呈钝形、闭塞段血管出现钙化;与CAG结果相比较,分析两者间显示的差异。结果 80例患者(82个CTO病变)CCTA结果显示82支血管闭塞,CCTA诊断CTO病变的敏感度为95.12%,特异度为97.14%;冠状动脉CTO病变45例(54.88%)位于右冠状动脉,CCTA测量闭塞段长度显著小于CAG测量所得,差异具有统计学意义[(28.29±14.15)mm vs.(38.90±23.48)mm,P0.001]。CCTA显示闭塞段血管近端呈钝形19例(23.17%),与CAG对照一致。CCTA显示58个(70.73%)CTO病变闭塞段血管内可见点状、结节状、条片状钙化灶,而CAG显示闭塞段血管存在钙化55个(67.07%),两者间比较差异无统计学意义(P0.05)。结论双源CT诊断冠状动脉CTO病变有较高敏感度及特异度,且可以显示闭塞段长度,近端形态及闭塞段钙化等有利于指导PCI治疗的形态学特征。     

高血压降压治疗目标的再认识

根据传统的高血压水平的定义,1993年WHO高血压治疗指南提出血压控制目标为<140/90mm Hg(1mm Hg=0.133kPa),但是并非所有患者都必须将血压降至同一水平,而应根据患者情况进行个体化治疗。Framingham进行的一项长达10～12年的心血管事件研究发现,第5年后,正常上限血压[收缩压(SBP     

State of knowledge of helminth fauna of freshwater fishes of Poland

A total 89 fish and lamprey species has been recorded from Polish freshwater habitats. Twenty-seven of them (30.3%) have not been surveyed for parasitic helminthes. Some of the latter fishes are either rare or not easily accessible. Other live only in specific habitats in scattered localities. An important obstacle for studying parasite faunas of some fishes may be their status on an endangered species. Among the non-surveyed fishes, are those which have been relatively recently introduced to Poland or migrated there on their own. The present paper attempts to review all hitherto not studied helminthologically fish species, their habitats, localities and current protection status.     

Complex of genotypes of cytokines as a genetic factor of risk of development of myocardial infarction of in Europien population of Russia men

Cytokines as regulators of activity of inflammation play significant role in mechanisms of formation of atherosclerotic plaques and in processes of their destabilization. One of leading genetic factors determining level of their production appears to be polymorphism of cytokine genes structure at their promoter loci. We have conducted an analysis of distribution in groups of healthy male and female survivors of myocardial infarction (MI) of combined genetic signs represented as a complex of genotypes of a number of studied cytokine genes : TNF-A863C; TNF-A308G; TNF-A238G; IL1B-C511T; IL1B-C-31T; IL4-C590T; IL6-C174G; IL10A-1082G IL10-A592C. Among these homozygous combinations of cytokine genotypes characterizing a group of men who have lived up to middle and old age without development of MI there are widely represented genotypes associated with high levels of production of both cytokines with pronounced proinflammatory (IL-1) and antiinflammatory (IL-4, IL-10) activity. Absence of such multidirectional combinations in genome of patients with myocardial infarction can be considered one of genetic factors of risk of development of acute distirbances of coronary circulation.