崔松,陈亚磊,王瑞,贺毅,栗佳南,田锐,葛长江,苑飞,黄榕翀,宋现涛,吕树铮

• 1:首都医科大学附属北京安贞医院心内科
• 2:首都医科大学附属北京安贞医院放射科
• 3:大连医科大学第一附属医院心内科

摘要(Abstract)：

目的运用CT血管造影(CT angiography,CTA)分析影响慢性完全闭塞病变(chronic total occlusion lesions,CTO)介入治疗的病变特征及对介入治疗结果的预测价值。方法入选113例患者,分为介入治疗成功组(64例)与介入治疗失败组(52例)。收集患者资料,运用CTA分析两组患者CTO特征,并采用多因素logistic回归分析判断影响CTO介入治疗成功的因素,利用ROC曲线判断并评价CT-CTO评分和日本CTO评分(J-CTO评分)的诊断效能。结果介入治疗失败组患者闭塞段近端分叉(75.0%比54.7%,P=0.042)、闭塞段远端纤维帽形态不清晰(17.3%比4.6%,P=0.023)、闭塞段内是否存在钙化病变(73.1%比53.1%,P=0.033)、闭塞段长度[(26.0±16.6)mm比(16.8±11.3)mm,P=0.003]、闭塞段长度≥20 mm(46.2%比25.0%,P=0.007)均高于介入治疗成功组,差异均有统计学意义。多因素logistic回归分析显示,闭塞段远端纤维帽形态不清晰、闭塞段近端分叉、闭塞长度≥20 mm是影响CTO介入治疗成功的主要因素。ROC曲线下的面积CT-CTO评分预测介入治疗成功率(87.8%比73.9%,P<0.05)高于J-CTO评分。结论闭塞段远端纤维帽形态不清晰、闭塞段近端分叉、闭塞段长度≥20 mm是影响CTO介入治疗成功的独立危险因素,CTA能够预测CTO介入治疗的成功率,与J-CTO评分相比,CT-CTO评分对介入治疗成功率具有更高的预测价值。

关键词(KeyWords)： CT血管造影;慢性完全闭塞病变;介入治疗

Abstract:

Keywords:

基金项目(Foundation): 首都临床特色应用研究与成果推广(Z161100000516139);; 北京力生心血管健康基金会领航基金项目(LHJJ20158521);; 大连医科大学转化医学项目(2015003)

作者(Author): 崔松,陈亚磊,王瑞,贺毅,栗佳南,田锐,葛长江,苑飞,黄榕翀,宋现涛,吕树铮

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