CT冠状动脉成像与钙化积分评价可疑冠心病患者预后

目的 探讨CT冠状动脉成像（CTCA）与钙化积分（CACS）对可疑冠心病患者预后的预测价值.方法 对150例可疑冠心病患者行前瞻性分析.所有患者均接受320排动态容积CT扫描,分析CTCA以及CACS结果,分析并对照CTCA以及CACS判断患者预后的价值.结果 85例患者CTCA发现非阻塞性冠状动脉病变（管腔狭窄≤50％）,38例患者发现阻塞性冠状动脉病变（管腔狭窄＞50％）,27例患者冠状动脉未发现异常.54例患者钙化积分在0～10之间,47例患者钙化积分在11～400之间,49例患者钙化积分大于400.冠状动脉狭窄程度、斑块的类型及钙化积分大小均为患者终点事件发生的危险因素（OR＝5.254,95％ CI=2.095-13.176,P＜0.001; OR=6.877,95％CI＝1.372-14.033,P＜0.001；OR=2.976,95％CI=1.437-6.614,P＝0.003）.冠状动脉狭窄程度、斑块类型对患者预后有显著影响（OR=3.725,95％CI=1.379-10.062,P=0.007;OR=4.283,95％CI=1.992-12.254,P＝0.002）.结论 CTCA和CACS对可疑冠心病患者预后有较高的预测价值,CTCA对患者的预后的预测价值优于CACS.

Prognostic value of computed tomography coronary angiography and coronary artery calcium score in patients with suspected coronary artery disease

Objective Our aim was to assess the prognostic value of computed tomography coronary angiography （CT- CA） and coronary artery calcium scoring （CACS） in pittients with suspected coronary artery disease（CAD）. Methods All patients underwent 320-row dynamic volume computed tomography. The results of CTCA and CACS were prospectively analyzed. The prognostic values of CTCA and CACS were investigated. Results Nonsignificant CAD was detected in 85 patients, significant CAD in 38 patients and absence Of CAD in 27 patients. CACS from 0 to 10 was found in 54 patients, 11 to 400 in 47 patients and CACS〉400 in 49 patients. The extent of stenosis, components of plaques and calcium scoring were recognized as risk factors of heart events （OR= 5.254, 95% CI = 2. 095-13.176, P 〈 0.001 ; OR = 6. 877, 95%CI = 1. 372-14. 033, P 〈0. 001; OR=2. 976, 95%CI= 1. 437-6. 614, P =0. 003）. The extent of stenosis and components of plaques were significant factors for prognosis of patients （OR=3. 725, 95%CI=1. 379-10. 062, P =0. 007; OR=4. 283, 95%CI=1. 992-12. 254, P =0. 002）. Conclusion For patients with suspected coronary artery disease （CAD）, CTCA and CACS have effective predictive value for heart events. Moreover, the prognostic value of CTCA＇is more effective than CACS.