CAJ | 학술논문

目的：应用256层螺旋 CT 冠状动脉成像（CTA）对不同年龄段的非 ST 段抬高性急性冠脉综合征（NSTEACS）患者的罪犯病变及斑块性质进行分析，探讨其在 NSTEACS 诊断中的应用价值。方法选取诊断为 NSTEACS 并在1周内行 CTA 和冠状动脉造影（CAG）者98例，常规收集病史资料及临床检查指标，按年龄分为≤50岁、＞50～70岁和≥70岁三组。所有入选患者首先应用256层螺旋 CT 进行 CTA 检查，接着在同一次住院期间通过 CAG 检查进一步确定其冠状动脉病变的情况。结果通过 CTA 检查98例 NSTEACS 患者中查出145个罪犯病变，以非钙化斑块及以钙化斑块为主的混合性斑块为最多见，占90．1％；256层 CTA 对NSTEACS 患者罪犯病变诊断的敏感度为98．2％，特异度高达99．1％。其中≤50岁组 CTA 对冠状动脉病变诊断的敏感度、特异度、阳性预测值、阴性预测值和准确诊断指数分别为：93．1％、98．5％、86．9％、96．2％、91．6％；50～70岁组的相关数据分别为：95．6％、98．2％、85．8％、95．9％、94．2％；≥70岁组的相关数据分别为：94．5％、97．7％、87．9％、95．6％、92．2％。结论256层 CTA 对 NSTEACS 患者罪犯病变的诊断有较高的敏感度、特异度，且与年龄无关。
목적：응용256층라선 CT 관상동맥성상（CTA）대불동년령단적비 ST 단태고성급성관맥종합정（NSTEACS）환자적죄범병변급반괴성질진행분석，탐토기재 NSTEACS 진단중적응용개치。방법선취진단위 NSTEACS 병재1주내행 CTA 화관상동맥조영（CAG）자98례，상규수집병사자료급림상검사지표，안년령분위≤50세、＞50～70세화≥70세삼조。소유입선환자수선응용256층라선 CT 진행 CTA 검사，접착재동일차주원기간통과 CAG 검사진일보학정기관상동맥병변적정황。결과통과 CTA 검사98례 NSTEACS 환자중사출145개죄범병변，이비개화반괴급이개화반괴위주적혼합성반괴위최다견，점90．1％；256층 CTA 대NSTEACS 환자죄범병변진단적민감도위98．2％，특이도고체99．1％。기중≤50세조 CTA 대관상동맥병변진단적민감도、특이도、양성예측치、음성예측치화준학진단지수분별위：93．1％、98．5％、86．9％、96．2％、91．6％；50～70세조적상관수거분별위：95．6％、98．2％、85．8％、95．9％、94．2％；≥70세조적상관수거분별위：94．5％、97．7％、87．9％、95．6％、92．2％。결론256층 CTA 대 NSTEACS 환자죄범병변적진단유교고적민감도、특이도，차여년령무관。
Objective To analyze the plaque characteristic in culprit lesions of patients with non-ST eleva-tion acute coronary syndrome (NSTEACS)in different age groups by 256-slice spiral CT coronary angiography (CTA),and explore its application value in NSTEACS.Methods 98 patients with non-ST elevation acute coronary syndrome (NSTEACS)who underwent CTA and CAG within a week were included during hospitalization from June 201 2 to October 201 3 The medical history and clinical examination data were collected.According to the age,the pa-tients were divided into three groups:≤50 years,50-70 years and ≥70 years.The 256-slice spiral CT were applied to examine CTA for all included patients and then CAG examination were conducted to confirm the situation of coronary lesions subsequently during the hospitalization.Results There were 1 45 culprit lesions among 98 patients by CTA examination,and the most common was mixed plaques (non-calcified and calcified plaques),which accounted for 90. 1 %.The sensitivity and specificity of the diagnostic procedure by 256-slice CTA in patients with NSTEACS was 98.2%and 99.1 % respectively.In the ≤50 age group,the sensitivity,specificity,PPV,NPV and accurate diagnosis index is93.1 %,98.5%,86.9%,96.2%,91 .6% respectively;the data of 50-70 age group was 95.6%,98.2%,85.8%, 95.9%,94.2%;the data of ≥70 age group was 94.5%,97.7%,87.9%,95.6%,92.2%.Conclusion The sensi-tivity and specificity of the diagnostic procedure is high in patients with NSTEACS by 256-slice CTA,among different age groups.