ST段抬高与非ST段抬高急性冠脉综合征的64层螺旋CT的影像差异

目的：探讨ST段抬高与非ST段抬高急性冠脉综合征（ACS）的64层螺旋CT冠状动脉造影的影像差异。方法：连续收集2009年10月-2011年4月间ST段抬高急性冠脉综合征（STEACS）患者30例及非ST段抬高急性冠脉综合征（NSTEACS）患者35例，均行64层螺旋CT冠状动脉造影。研究其冠状动脉斑块的发生部位、数目、性质、斑块所致的狭窄程度以及伴或不伴有主要冠状动脉血管中断、心肌梗死等方面的影像差异。结果：冠状动脉非钙化斑块的发生率、单发病变以及单支血管累及率在STEACS组中均高于NSTEACS组（P〈o．05），并且心肌缺血以及血管中断发生率较NSTEACS组高（P〈o．05）；而冠状动脉的钙化斑块、多发病变以及多支血管累及率在NSTEACS组均高于sTEACS组（P〈0．05）。结论：STEACS及NSTEACS患者的冠状动脉及心肌病变具有各自的特点，这对临床采取相应的治疗措施具有较大的价值。

The differences of 64-MDCT findings of acute coronary artery syndrome with and without ST segment elevation

Objective： To investigate the CT finding difference between non-ST segment elevation acute coronary artery syn- dromes （NSTEACS） and ST segment elevation acute coronary artery syndromes（STEACS） by 64 MDCT angiography. Meth- ods： Sixty-five acute coronary artery syndrome patients who underwent 64-MDCT angiography from Oct 2009 to Apr 2011, which included NSTEACS（n= 35）and STEACS （n= 30）. We compared with the plaque nature,stenosis,involved artery num- ber,and with or without coronary artery obstructed and myocardial infarction. Results： There was significant stastieal difference in STEACS group such as non-calcified plaque, single coronary artery involved, isolated lesion incidence, myocardial infarction and stem artery obstructed ineidence（P〈0.05） ,while also significant stastical difference in NSTEACS group such as calcified plaque,multi-artery involved,multiple lesions incidence（P〈0.05）. Conclusion： There are difference findings in STEACS and NSTEACS by 64-MDCT angiography. It＇s useful for physicians to make a difference between STEACS and NSTEACS.