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目的探讨GE 128层螺旋CT在评价冠状动脉狭窄的同时,测定左心室功能的应用价值。方法回顾性分析433例MSCT冠状动脉造影老年患者临床资料,计算冠状动脉钙化积分(分为4组:Ⅰ组钙化积分为0,0<Ⅱ组≤100,100<Ⅲ组≤400,Ⅳ组>400)。冠状动脉狭窄程度以测量血管直径法分为Ⅰ~Ⅳ组(Ⅰ组正常,Ⅱ组为轻度狭窄≤50%,50%<Ⅲ组为中度狭窄≤75%,Ⅳ组为重度狭窄>75%)。并计算左心室的舒张末期容积(EDV)、收缩末期容积(ESV)、每搏输出量(SV)、射血分数(EF)。结果 (1)冠状动脉狭窄程度与左心室收缩功能关系:组间两两比较,EF值,正常组与轻度狭窄组间差异无统计学意义(P>0.05);EDV值,仅重度狭窄组与其他3组间差异有统计学意义(P<0.01),正常组、轻度组及中度狭窄组间差异无统计学意义(P>0.05);ESV值,正常组与轻度狭窄组间差异无统计学意义(P>0.05);SV值,重度组与正常组间差异有统计学意义(P<0.01)。(2)冠状动脉钙化积分与左心室收缩功能关系:组间两两比较,EF值,正常组与轻度、中度钙化组间差异无统计学意义(P>0.05);EDV值,仅重度狭窄组与其他3组间差异有统计学意义(P<0.01),正常组、轻度组及中度狭窄组间差异无统计学意义(P>0.05);ESV值,正常组与轻度狭窄组间差异无统计学意义(P>0.05)。结论随着冠状动脉管径狭窄的增加,左室收缩功能有不同程度的下降;随着冠状动脉钙化积分的增加,左室收缩功能有不同程度的下降;128层螺旋CT在冠状动脉硬化狭窄及左室收缩功能定量评价方面准确、可靠,一次MSCT冠状动脉造影检查可以同时评估冠状动脉狭窄情况和左心室功能。
Objective To evaluate the value of GE 128-slice spiral CT in assessing coronary artery stenosis and measuring left ventricular function. Methods The clinical data of 433 elderly patients with MSCT coronary angiography were retrospectively analyzed. The coronary artery calcification scores were calculated (divided into 4 groups: group I with calcification score 0, group 0 400) . The degree of coronary artery stenosis was divided into group Ⅰ ~ Ⅳ (group Ⅰ, group Ⅱ, stenosis ≤50%, group Ⅲ, stenosis≤75%, group Ⅳ, stenosis 75, %). Left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) were calculated. Results (1) The relationship between the severity of coronary artery stenosis and left ventricular systolic function: There was no significant difference between two groups in the EF, normal group and mild stenosis group (P> 0.05); EDV value, severe stenosis group (P <0.01). There was no significant difference between normal group, mild group and moderate stenosis group (P> 0.05). The ESV value between normal group and mild stenosis group There was no significant difference between the two groups (P> 0.05). There was significant difference between SV group and normal group (P <0.01). (2) The relationship between coronary artery calcification score and left ventricular systolic function: There were no significant differences in EF between normal group and mild and moderate calcific group (P> 0.05); EDV value, only severe The difference between the stenosis group and the other three groups was statistically significant (P <0.01), there was no significant difference between the normal group, the mild group and the moderate stenosis group (P> 0.05); ESV value, normal group and mild stenosis There was no significant difference between groups (P> 0.05). Conclusion With the increase of stenosis of coronary artery, left ventricular systolic function declines to some extent. With the increase of coronary artery calcification score, the left ventricular systolic function declines to some extent. In 128 cases with coronary artery stenosis and Accurate and reliable quantitative evaluation of left ventricular systolic function, a MSCT coronary angiography can simultaneously assess the situation of coronary stenosis and left ventricular function.