胸痛与非胸痛患者CT冠状动脉成像的对照研究

目的 探讨64层螺旋CT冠状动脉成像(CTCA)对胸痛患者冠状动脉病变的临床应用价值。 方法 将2012年2月-2014年4月在马鞍山市人民医院行CTCA检查的105例患者按主诉分为胸痛组和非胸痛组,回顾性比较分析2组患者一般资料、冠状动脉斑块阳性病例数、斑块性质、节段数目和管腔狭窄程度的差异。 结果 胸痛组56例,冠状动脉斑块阳性者45例,共176节段,其中非钙化斑块77节段、钙化斑块64节段、混合斑块35节段,0级狭窄患者11例、1级狭窄33例、2级狭窄6例、3级狭窄6例;非胸痛组49例,冠状动脉斑块阳性者23例,共69节段,其中非钙化斑块44节段、钙化斑块17节段、混合斑块8节段,0级狭窄患者26例、1级狭窄18例、2级狭窄1例、3级狭窄4例。2组性别比较差异无统计学意义(χ2=3.26,P=0.07);2组平均年龄比较差异无统计学意义(t=0.64,P=0.52);胸痛组冠状动脉斑块阳性病例数显著高于非胸痛组(χ2=12.79,P<0.001);2组斑块性质差异有统计学意义(χ2=8.03,P=0.02);2组冠状动脉斑块节段数目对比差异有统计学意义(Z=-3.71,P<0.001);2组管腔狭窄程度比较差异有统计学意义(Z=-3.33,P<0.001)。 结论 CTCA检查显示,胸痛患者冠状动脉斑块阳性例数和节段数目、管腔狭窄程度均高于非胸痛患者,斑块性质构成也有所不同,因此CTCA对于胸痛患者冠状动脉病变具有重要的临床应用价值。 

Comparative study of CT coronary angiography in patients with chest pain and patients without chest pain

Objective To explore clinical application value of 64-slice CT coronary angiography (CTCA) in diagnosis of coronary artery diseases with chest pain as the chief complaint. Methods In accordance with the chief complaint with or without chest pain,105 hospitalized patients with CTCA examination were divided into chest pain group and non-chest pain group.In addition to the general information of patients,the difference in coronary artery diseases such as the positive rate,the plaque composition,the plaque segment quantity and the degree of stenosis between two groups was compared retrospectively. Results Among 56 patients with chest pain,45 cases were diagnosed with coronary artery plaque as 176 segments in total were observed,including 77 non-calcified plaques,64 calcified plaques and 35 mixed plaques.Insofar as stenosis was concerned,11 patients were found at level 0,33 patients at level 1,6 patients at level 2 and 6 patients at level 3.Among 49 patients without chest pain,23 cases were diagnosed with coronary artery plaque as 69 segments in total were observed,including 44 non-calcified plaques,17 calcified plaques and 8 mixed plaques.Insofar as stenosis was concerned,26 patients were found at level 0,18 patients at level 1,1 patients at level 2,4 patients at level 3.Gender between two groups had no significant statistical difference (χ2=3.26,P=0.07);the average age between two groups had no significant statistical difference (t=0.64,P=0.52);the positive rate of chest pain group were higher than non-chest pain group (χ2=12.79,P<0.001);plaque composition had significant statistical differences (χ2=8.03,P=0.02);the plaque segment quantity had significant statistical differences (Z=-3.71,P<0.001);the degree of luminal stenosis had significant statistical differences (Z=-3.33,P<0.001),the mean rank of chest pain group was 61.48,higher than 43.31 of non-chest pain group. Conclusion CTCA showed that the positive plaques,the plaque segment quantity and the degree of luminal stenosis in patients with chest pain were higher than those in patients without chest pain.In addition,plaque composition between two groups had significant statistical difference.Therefore,CTCA has important clinical value in diagnosis of coronary artery diseases with chest pain as the chief complaint.