CAJ | 학술논문

目的：观察双源CT（DSCT）在评价冠心病患者经皮冠状动脉介入治疗（PCI）术后支架通畅性及左心室功能中的应用。方法2010年1月至2011年12月入选的90例患者，共植入支架162枚，于PCI术后12个月分别行冠状动脉造影及 DSCT检查（二者相隔5～7 d）。利用DSCT分析冠状动脉支架狭窄情况，应用左心室功能分析软件分别测定和计算左心室的射血分数、每搏输出量、收缩末容积、舒张末容积等参数。同时利用超声心动图测量上述指标。结果90例患者中，冠状动脉造影显示6例患者出现再狭窄（6．7％），DSCT显示7例患者出现再狭窄（7．7％）。相比冠状动脉造影，DSCT的敏感性为83．3％，特异性为97．6％，准确性为96．7％，阳性预测值71．4％，阴性预测值98．8％。冠状动脉造影结果显示共有11枚支架出现再狭窄，双源 CT能检测出10枚支架出现再狭窄，支架再狭窄检出率二者分别为6．8％、6．2％，差异无统计学意义（P＞0．05）。相比冠状动脉造影，DSCT敏感性为72．7％，特异性为98．7％，准确性为96．9％，阳性预测值80．0％，阴性预测值98．0％。舒张末容积、收缩末容积、每搏输出量、左心室射血分数在心脏超声和DSCT之间存在较好的相关性（P＜0．05）。结论双源 CT可用于 PCI术后支架通畅性及左心室功能的评价。
목적：관찰쌍원CT（DSCT）재평개관심병환자경피관상동맥개입치료（PCI）술후지가통창성급좌심실공능중적응용。방법2010년1월지2011년12월입선적90례환자，공식입지가162매，우PCI술후12개월분별행관상동맥조영급 DSCT검사（이자상격5～7 d）。이용DSCT분석관상동맥지가협착정황，응용좌심실공능분석연건분별측정화계산좌심실적사혈분수、매박수출량、수축말용적、서장말용적등삼수。동시이용초성심동도측량상술지표。결과90례환자중，관상동맥조영현시6례환자출현재협착（6．7％），DSCT현시7례환자출현재협착（7．7％）。상비관상동맥조영，DSCT적민감성위83．3％，특이성위97．6％，준학성위96．7％，양성예측치71．4％，음성예측치98．8％。관상동맥조영결과현시공유11매지가출현재협착，쌍원 CT능검측출10매지가출현재협착，지가재협착검출솔이자분별위6．8％、6．2％，차이무통계학의의（P＞0．05）。상비관상동맥조영，DSCT민감성위72．7％，특이성위98．7％，준학성위96．9％，양성예측치80．0％，음성예측치98．0％。서장말용적、수축말용적、매박수출량、좌심실사혈분수재심장초성화DSCT지간존재교호적상관성（P＜0．05）。결론쌍원 CT가용우 PCI술후지가통창성급좌심실공능적평개。
Objective To investigate the evaluation of the stents patency and the left ventricular function after coronary artery stents implantation by dual-source computed tomography (DSCT)coronary angiography.Methods 90 patients with PCI(162 im-plantation stents)from January 2010 to December 2011 in our hospital were selected and performed the coronary angiography and DSCT examination(5-7 d apart)in 1 2 months after PCI operation.Meanwhile,DSCT was adopted to analyze the coronary stent stenosis and the left function anaaysis software was used to detect and calculate the left ventricular function related indexes:EDV, ESV,SV,LVEF.Results Among 90 cases,the coronary angiography displayed 6 cases of stent restenosis(6.7%),DSCT displayed 7 cases of stent restenosis(7.7%).Compared with the coronary angiography,the sensitivity,specificity,accuracy,positive prediction value and negative prediction value in DSCT were 83.3%,97.6%,96.7%,71.4% and 98.8% respectively.Among 162 stents,the coronary angiography displayed 11 stents with restenosis(6.8%)and DSCT displaye 10 stents with restenosis(6.2%,P>0.05). Compared with the coronary angiography,the sensitivity,specificity,accuracy,positive prediction value and negative prediction value in DSCT were 72.7%,98.7%,96.9%,80.0% and 98.0%.The results of EDV,ESV,SV and LVEF showed better correlation be-tween cardiac ultrsonography and DSCT(P<0.05).Conclusion DSCT can be used to evaluate the stent patency and the left ven-tricular function after PCI.