刘博清,余再新

• 1:中南大学湘雅医学院
• 2:中南大学湘雅医院心内科

摘要(Abstract)：

心血管病死亡是当前我国最主要的死亡原因之一，在临床上多以动脉粥样硬化斑块快速进展相关的急性冠状动脉综合征为主要表现。既往多针对伴发多种危险因素的患者采用指南推荐的冠心病二级预防措施以降低心血管事件发生率。现代医疗背景下，影像学技术的进展使得识别高危斑块特征成为可能，为改善靶向斑块的治疗措施评估提供了依据。近些年研究发现，他汀类药物、前蛋白转化酶枯草杆菌蛋白酶9抑制剂等降脂类药物可通过改善血脂代谢、逆转斑块，为冠心病患者强化降脂治疗提供了有力证据。此外，秋水仙碱、西洛他唑、不饱和脂肪酸等可介导炎症状态、改善内皮功能进而改善斑块性质，成为靶向斑块逆转的潜在治疗药物。冠状动脉CT血管造影（CCTA）检查创伤小、普及性高，相较于冠状动脉造影及其他腔内影像学技术，更适用于斑块性质连续评估。随着CCTA技术革新，其空间分辨率、时间分辨率更加精确，结合心脏体积覆盖与重建算法实现了更高质量的成像与丰富的解剖细节。本文对CCTA评估斑块性质的定性与定量指标进行介绍，并对近些年使用CCTA评估药物治疗改善斑块性质的临床研究进行综述，以期对于临床治疗提供参考与指导。

关键词(KeyWords)： 动脉粥样硬化斑块;冠状动脉CT血管造影;药物治疗

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目（82070055,82100071）;; 省级大学生创新创业训练计划支持项目（S202310533463）

作者(Author): 刘博清,余再新

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