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     

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...     

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     

血流储备分数指导冠状动脉旁路移植术的现状与探索

<正>长久以来,对于冠状动脉旁路移植术(coronary artery bypass grafting,CABG)的实施主要是根据冠状动脉造影(coronary angiography,CAG)检查,由心外科医生根据造影结果进行评估,判断狭窄病变的严重程度并决定需要手术处理的狭窄冠状动脉病变位置~([1])。目前外科冠状动脉血运重建指征是左主干直径狭窄≥50%或者3支主要冠状动脉狭窄≥70%~([1])。然而,在所有冠状动脉解剖狭窄中,约有40%的形态     

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.     

远端桡动脉入路在冠状动脉造影及介入中的研究进展

远端桡动脉入路(distal transradial access,dTRA)是对冠心病患者行冠状动脉造影(coronary angiography,CAG)及经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)的一种新的手术途径,近年来,国内外心血管病医生都在尝试这一新...     

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...     

双源CT冠状动脉造影在冠状动脉狭窄中的诊断价值

<正>选择性冠状动脉造影(CAG)一直被认为是确诊冠状动脉狭窄和病变的"金标准",但其属于有创检查,存在并发症,且费用较高而难以被大多数患者所接受。随着CT影像技术的发展,多排螺旋CT冠状动脉成像在临床中应用越来越多,双源CT(DSCT)时间分辨率高、成像不受心率影响,且属于无创检查,受到广大医务人员的认可。本文通过比较CAG和DSCT冠状动脉造影,探讨DSCT冠状动脉造影在诊断冠状动脉狭窄中     

川崎病患者选择性冠状动脉造影单中心特点及经验分析

目的 总结昆明市儿童医院川崎病并发严重冠状动脉病变(coronary artery lesion,CAL)患者选择性冠状动脉造影(coronary angiography,CAG)的特点及经验.方法 回顾性分析2017年7月至2019年10月在昆明市儿童医院行CAG的32例川崎病患儿临床资料,男23例,女9例,年龄5岁...     

影响多层螺旋CT冠状动脉成像图像质量的因素

虽然迄今为止冠心病诊断的金标准仍为冠状动脉造影(coronary angiography,CAG),但CAG仅能显示管腔的狭窄程度及范围,而且是有创检查,还可能出现一些严重的并发症.多层螺旋CT冠状动脉成像(multi-slice spiral CT coronary angiography,MSCTCA)不但可以显示血管管腔的改变,亦可同时显示管壁的钙化、斑块的形态、范围、特征及血管与心脏整体间的空间关系[1],且其为无创性检查,费用较低,因此越来越受到关注.本文主要探讨影响MSCTCA图像质量的因素.     

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.     

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     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.