CT定量分析在冠心病介入治疗前后血流灌注改变的评估价值

摘要 目的：探讨CT定量分析在冠心病介入治疗前后血流灌注改变的评估价值。方法：2018年2月到2020年11月选择在本院诊治的冠心病患者95例作为研究对象，所有患者都给予经皮冠状动脉介入治疗，在介入前1 d与介入后1个月进行CT定量与超声检查，随访介入后6个月的冠状动脉再狭窄情况并进行相关性分析。结果：所有患者都顺利完成介入治疗，介入期无严重并发症发生。95例患者介入后1个月的左室射血分数(ejectionfraction，EF)、左室短轴缩短率(fractionalshortening，FS)高于介入前1 d(P<0.05)，介入前后左室等容舒张时间(iso-volumicrelaxationtime，IVRT)对比差异无统计学意义(P>0.05)。95例患者介入后1个月的心肌血流量(Myocardialbloodflow，MBF)、心肌血容量(Myocardialbloodvolume，MBV)高于介入前1d(P<0.05)，达峰时间(Timetopeak，TTP)低于介入前1 d(P<0.05)。介入后随访6个月，冠状动脉再狭窄14例，再狭窄率14.7 %，其中中度狭窄12例，重度狭窄2例；Pearson分析显示冠心病患者介入前1 d的MBF、MBV、TTP与FS、EF都存在相关性(P<0.05)；Logistic回归分析显示MBF、MBV、TTP、FS、EF为影响冠心病患者介入后随访再狭窄率的重要因素(P<0.05)。结论：CT定量分析在冠心病介入前后的应用能有效反映血流灌注改变情况，且与患者的心功能存在相关性，也可有效预测患者介入随访冠状动脉再狭窄发生情况。

The Evaluation Value of CT Quantitative Analysis before and after Intervention of Cardiovascular Disease

ABSTRACT Objective: To explore the evaluation value of CT quantitative analysis of blood perfusion changes before and after intervention for cardiovascular disease. Methods: From February 2018 to November 2020, 95 cases of patients with coronary heart disease who were diagnosed and treated in our hospital were selected as the research objects. All patients were treated with percutaneous coronary intervention, and CT quantification were performed 1d before intervention and 1 month after the intervention with ultrasound examination, followed-up of coronary artery restenosis 6 months after intervention and conducted correlation analysis. Results: All patients were successfully completed the interventional treatment, and there were no serious complications occurred during the interventional period. The left ventricular ejection fraction (EF) and left ventricular short-axis shortening rate (FS) in the 95 patients 1 month after intervention were higher than those of 1 day before intervention (P<0.05), and the the difference in the left ventricular isovolumic relaxation time compared before and after intervention (iso-volumicrelaxationtime, IVRT) were not statistically significant (P>0.05). The myocardial blood flow (MBF) and myocardial blood volume (MBV) of 95 patients at 1 month after intervention were higher than 1 day before intervention (P<0.05), and time to peak (TTP) were lower than 1 day before intervention (P<0.05). Followed-up 6 months after intervention, 14 cases of coronary artery restenosis, restenosis rate 14.7 %, of which 12 cases were moderate stenosis, 2 cases were severe stenosis; Pearson analysis showed that MBF, MBV, TTP at 1 day before intervention of coronary heart disease patients were correlation to the FS and EF (P<0.05); Logistic regression analysis shows that MBF, MBV, TTP, FS, EF were important factors that affected the rate of restenosis in patients with coronary heart disease after intervention (P<0.05). Conclusion: The application of CT quantitative analysis before and after intervention of coronary heart disease can effectively reflect the changes of blood flow perfusion, and are related to the patient''s cardiac function, and can also effectively predict the occurrence of coronary artery restenosis in patients with interventional follow-up.