应用64层CT评价左冠状动脉前降支动脉硬化狭窄程度与左心功能的相关性
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The Correlation Between Atherosclertic Stenosis of Left Anterior Descending Coronary Artery and Left Ventricular Function by 64-Slice CT
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    目的利用64层CT对左冠状动脉前降支动脉硬化狭窄与左心功能变化之间的相关性进行评估。方法经64层CT确诊的左冠状动脉前降支动脉硬化狭窄共104例,正常对照20例,均行64层螺旋CT心功能分析,分别计算出左心室质量、左心室射血分数、左心室舒张期末容积和左心室收缩期末容积等参数。根据管腔狭窄程度把104例左冠状动脉前降支硬化狭窄患者分为轻度(管腔狭窄<50%)、中度(管腔狭窄50%~75%)和重度狭窄组(管腔狭窄>75%),并进行统计学分析。结果与正常对照组比较,轻度狭窄组心功能参数无显著变化;中度狭窄组主要表现为左心室质量增加,左心室收缩期末容积增加,左心室射血分数减小;重度狭窄组表现为多发软斑块或混合性斑块,心功能明显减低。左心室射血分数与左冠状动脉前降支狭窄程度呈负相关,重度狭窄组左心室射血分数较轻度狭窄组和中度狭窄组显著降低(P<0.05)。左心室收缩期末容积与左冠状动脉前降支狭窄程度呈正相关(r=0.84,P<0.05)。左心室舒张期末容积在中度狭窄组与重度狭窄组之间差异有显著性性(P<0.05),其随管腔狭窄程度升高而逐渐增大。结论随着左冠状动脉狭窄程度加重,心功能经历代偿到失代偿动态过程,64层CT在评价冠状动脉硬化狭窄程度与心功能相关性方面具有重要价值。

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    Aim To evaluate the correlation between the left antetior descending coronary artery(LAD) atherosclerotic stenosis and cardiac function by 64-slice spiral CT,and to discuss the mainly imaging findings.Methods 104 cases with the LAD atherosclerotic stenosis and 20 cases of controls were studied.All cases underwent 64-row CT coronary angiography,and the data were transferred to Vitrea 2.0 work station.Then,the parameters including left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV),left ventricular myocardial mass(LVMM) were calculated.All data were analyzed with statistical software.Results There were no significant difference of cardiac functions in mild stenosis group compared with control group,and in moderate stenosis group,LVMM and LVESV increased,while LVEF decreased in a small percentage.Statistical differences of LVEF,LVEDV,LVESV,LVMM could be found in severe stenosis group compared with mild stenosis group,moderate stenosis group and the control group.Conclusion With the stenosis of the LAD increasing,the change is a dynamic process from chronic adjustment to cardiac dysfunction.64-slice spiral CT can evaluate the changes and correlations accurately.

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杨蓓,金朝林,张树桐,肖建伟.应用64层CT评价左冠状动脉前降支动脉硬化狭窄程度与左心功能的相关性[J].中国动脉硬化杂志,2011,19(9):777~780.

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  • 收稿日期:2011-05-01
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