冠状动脉CT血管造影对心绞痛斑块性质及预后的评估价值分析

目的 探究冠状动脉CT血管造影（CTA）对心绞痛斑块性质及预后的评估价值。 方法 回顾性分析2018年8月1日至2019年7月31日南京市高淳人民医院收治的139例心绞痛患者的临床资料，根据心绞痛分型分为稳定型心绞痛（SAP）组（n=50）和非稳定型心绞痛（UAP）组（n=89）。所有患者均行CTA，比较2组患者的斑块性质情况并分析斑块性质与预后的关系。2组计量资料的比较采用配对t检验；计数资料的比较采用χ2检验。 结果 UAP组患者软斑块发生率明显高于SAP组患者41.99%（152/362）对18.24%（31/170），χ2=28.92，P<0.01]，钙化斑块发生率明显低于SAP组患者38.12%（138/362）对61.76%（105/170），χ2=26.06，P<0.01]。UAP组的89例患者中，有25例患者发生心血管事件，其中心力衰竭5例、急性心肌梗死5例、UAP反复发作15例；预后不良患者的软斑块发生率明显高于预后良好患者72.73%（80/110）对28.57%（72/252），χ2=61.29，P<0.05]，而钙化斑块发生率明显低于预后良好的患者7.27%（8/110）对51.59%（130/252），χ2=63.75，P<0.05]。SAP组的50例患者中，有5例患者发生心血管事件，其中急性心肌梗死1例、发展为UAP4例；预后不良患者的软斑块发生率明显高于预后良好患者57.89%（11/19）对13.25%（20/151），χ2=22.57，P<0.05]，而钙化斑块发生率明显低于预后良好患者21.05%（4/19）对66.89%（101/151），χ2=15.01，P<0.05]。 结论 冠状动脉CTA能有效评估斑块性质，预测患者的预后情况。

Value of coronary CT angiography in evaluating the nature and prognosis of angina pectoris plaque

Objective To explore the value of coronary CT angiography in evaluating the nature and prognosis of angina pectoris plaque. Methods A retrospective analysis of 139 patients with angina pectoris treated in Gaochun People's Hospital of Nanjing was conducted from 1 August 2018 to 31 July 2019. According to their clinical data, they were divided into stable angina pectoris (SAP, n=50) group and unstable angina pectoris (UAP, n=89) group. The plaque properties of the two groups were compared, and the relationship between their plaque properties and prognosis was analyzed. The measurement data of the two groups were compared by paired t test. The count data were compared by χ2 test. Results The rate of soft plaque detection in the UAP group was significantly higher than that in SAP group (41.99% (152/362) vs. 18.24% (31/170)), and the rate of calcified plaque detection was significantly lower than that in the SAP group (38.12% (138/362) vs. 61.76% (105/170)) (χ2=28.92 and 26.06, both P<0.01). Among the 89 patients in the UAP group, 25 patients had cardiovascular events, including 5 cases of heart failure, 5 cases of acute myocardial infarction, and 15 cases of recurrent UAP. The rate of soft plaque detection in patients with poor prognosis in the UAP group was significantly higher than that in patients with good prognosis (72.73% (80/110) vs. 28.57% (72/252), χ2=61.29, P<0.05), and the rate of calcified plaque detection was significantly lower than that in patients with good prognosis (7.27% (8/110) vs. 51.59% (130/252), χ2=63.75, P<0.05). Among the 50 patients in the SAP group, 5 patients had cardiovascular events, including 1 case of acute myocardial infarction and 4 cases of UAP. The rate of soft plaque detection in patients with poor prognosis in the SAP group was significantly higher than that in patients with good prognosis (57.89% (11/19) vs. 13.25% (20/151), χ2=22.57, P<0.05), and the rate of calcified plaque detection was significantly lower than that in patients with good prognosis (21.05% (4/19) vs. 66.89% (101/151), χ2=15.01, P<0.05). Conclusion Coronary CT angiography can effectively assess the nature of plaque and predict the prognosis of patients.