基于CCTA分析血流储备分数和冠状动脉斑块特征诊断心肌缺血的效能评价
Evaluation of the Diagnostic Efficacy of Myocardial Ischemia Based on CCTA Analysis of Flow Reserve Fraction and Coronary Plaque Character-istics
滕菲 1刘纯岩 1姜海余 1韩庆贺1
作者信息
- 1. 130000 长春,吉林大学第二医院放射线科
- 折叠
摘要
目的 探讨基于冠状动脉CT血管成像(CCTA)分析血流储备分数(FFR)、冠状动脉斑块特征对冠心病心肌缺血的诊断价值.方法 选取2021 年1 月—2023 年1 月收治的40 例冠心病心肌缺血作为研究组,另选同期40例冠心病非心肌缺血作为对照组.2 组均行CCTA检查,获取FFR、冠状动脉斑块特征参数.比较 2 组血清心肌缺血相关标志物[缺血修饰白蛋白(IMA)、心型脂肪酸结合蛋白(H-FABP)]、FFR、冠状动脉斑块特征参数.分析研究组FFR、冠状动脉斑块特征参数与血清心肌缺血相关标志物、心肌缺血程度相关性,评价FFR、冠状动脉斑块特征参数对心肌缺血的诊断效能.结果 研究组FFR低于对照组,斑块长度长于对照组,总斑块负荷以及血清IMA、H-FABP水平高于对照组(P＜0.01).FFR与血清IMA、H-FABP水平及心肌缺血程度呈负相关,斑块长度、总斑块负荷分别与之呈正相关(P＜0.01).受试者工作特征曲线分析显示,FFR、斑块长度、总斑块负荷联合诊断心肌缺血的曲线下面积大于血清IMA、H-FABP联合诊断,且诊断效能明显改善(P＜0.05).结论 基于CCTA分析FFR、冠状动脉斑块特征参数对冠心病心肌缺血具有一定诊断价值,且联合检测可明显提高诊断效能.
Abstract
Objective To explore the diagnostic value of flow reserve fraction(FFR)and coronary plaque character-istics in myocardial ischemia in patients with coronary heart disease(CHD)based on coronary CT angiography(CCTA).Methods Forty CHD patients with myocardial ischemia admitted from January 2021 to January 2023 were selected as the re-search group,and another 40 CHD patients without myocardial ischemia in the same period were selected as the control group.CCTA examination was performed in both groups to obtain FFR and coronary plaque characteristic parameters.Serum myocar-dial ischemia-related markers[ischemia modified albumin(IMA),heart type-fatty acid binding protein(H-FABP)],FFR and coronary plaque characteristic parameters were compared between the two groups.The correlation between FFR,coronary plaque characteristic parameters,serum myocardial ischemia-related markers and severity of myocardial ischemia was analyzed in the research group,and the diagnostic efficacy of FFR and coronary plaque characteristic parameters on myocardial ischemia was evaluated.Results The FFR of the research group was lower than that of the control group,the plaque length was longer than that of the control group,and the total plaque load and serum IMA and H-FABP levels were higher than those of the con-trol group(P＜0.01).FFR was negatively correlated with IMA and H-FABP levels and severity of myocardial ischemia,while plaque length and total plaque load were positively correlated with FFR(P＜0.01).The analysis of receiver operating characteristic(ROC)curve showed that the area under the ROC curve of FFR,plaque length and total plaque load in combi-nation for the diagnosis of myocardial ischemia was greater than that of the combination of serum IMA and H-FABP,and the diagnostic efficiency of the combination was significantly improved(P＜0.05).Conclusion CCTA based analysis of FFR and coronary plaque characteristic parameters has certain diagnostic value for myocardial ischemia in CHD patients,and the combined detection can significantly improve the diagnostic efficiency.
关键词
冠心病/心肌缺血/冠状动脉CT血管成像/血流储备分数/冠状动脉斑块特征/缺血修饰白蛋白/心型脂肪酸结合蛋白/诊断Key words
Coronary heart disease/Myocardial ischemia/Coronary computed tomographyangiography/Fractional flow reserve/Coronary plaque characteristics/Ischemia modified albumin/Heart type-fatty acid binding protein/Diagnosis引用本文复制引用
基金项目
2019年度吉林省卫生健康委科技能力提升计划(201902JL288)
出版年
2023
国家科技期刊平台
NSTL
万方数据