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1、DSA冠狀動(dòng)脈造影在冠狀動(dòng)脈病變?cè)\斷中的價(jià)值作者:肖榜喜 鐘燕青 鄭湞湞【關(guān)鍵詞】冠狀動(dòng)脈 摘要:目的:分析86例冠狀動(dòng)脈造影(CAG)的診斷結(jié)果,評(píng)價(jià)DSA―CAG對(duì)冠狀動(dòng)脈病變的診斷價(jià)值。方法:應(yīng)用DSA選擇性CAG證實(shí)病變≥50%直徑狹窄病例63例,依病變狹窄程度累及冠狀動(dòng)脈部位、數(shù)目、形態(tài)、冠狀動(dòng)脈優(yōu)勢(shì)狀況、側(cè)支循環(huán)及心肌梗死病例、左室壁運(yùn)動(dòng)情況和射血分?jǐn)?shù)(EF)等進(jìn)行統(tǒng)計(jì)分析。結(jié)果:50%狹窄或閉塞63例(73%)冠狀動(dòng)脈右優(yōu)勢(shì)型41例(66%),左優(yōu)勢(shì)型7例(11%)均衡型12例(20%),單支病變22例(36%)雙支病變17例(27%),3支病變20例(32%)受累血管104
2、支136處,重度狹窄及閉塞28處(45%),12例(19%)有不同程度側(cè)支循環(huán)形成,32例做了左心室造影射血分?jǐn)?shù)(LVEF)及室壁運(yùn)動(dòng)縮率分析,EF≥50%的20例(66%),EF40%~50%的7例(22%),<40%2例(7%),經(jīng)統(tǒng)計(jì)學(xué)分析,嚴(yán)重冠狀動(dòng)脈狹窄與閉塞合并室壁瘤者與單純狹窄病變LVEF差異有極顯著意義(P<0.01)。結(jié)論:冠狀動(dòng)脈循環(huán)與分布多數(shù)為右優(yōu)勢(shì)型,冠狀動(dòng)脈病變多累及前降支(LAD),其次為右冠狀動(dòng)脈(RCA)及左回旋支(LCF),病變程度多為嚴(yán)重狹窄,側(cè)支循環(huán)形成良好者對(duì)左心室功能有保護(hù)作用,高質(zhì)量的DSA設(shè)備是開展冠心病介入的重要基礎(chǔ),DSA-CAG對(duì)冠狀脈病變
3、的診斷有重要價(jià)值?! £P(guān)鍵詞:DSA;冠狀動(dòng)脈造影術(shù);冠心病;射血分?jǐn)?shù) TheDiagnosticValueofDSACoronaryAngiographyonCHD Abstract:Objective:Analysis86-patientswithcoronaryheartdiseaseunderwentCAG.ToevaluatediagnosticvalueofDSAcoronaryangiographyoncoronaryheartdisease.Methods:All86cases63ofthemcoronaryarterystenosis≥50%shownbyDSAwere
4、selectivelyanalyzedstatisticalanalyseswereinvolvedinthedegreelocationamountandshapeofthestenosis.thedistributionandcollateralcirculationofcoronaryartery,theleftventricularwallmotionandeject`fraction(EF).Results:In63casesofcoronaryarterystenosis≥50%occlusion,therewere41.7and12caseswithright,leftandb
5、alanceddominantarterydistribution,respectively;22,17and20caseswithsingle-vessel,double-vesselandtriple-vessellesions,respectivelythereweretotal136lesionsin104vessel,where28-lesions(45%)wereseriousnarrowingorocclusion12-patients(19%)hadvariedcollateralcirculationformation.bothleftventricularejection
6、fraction(LVEF)andwallmotionanalysesin32-patientsshowed20caseswithEF≥350%,7-withEF40%50%and2-withEF<40%.therewasasignificantdifferencebetweenLVEFofseriousstenosesorocclusioncomplicatedwithventricularaneurysmandthatofsimplestenoses(p<0.01).Conclusion:Mostcoronarydistributionsarerightdominantint
7、hissereiescoronaryheartdiseasemostlyinvolvesLAD,thenRCAandLCF,andalsothedegreeofstenosisismostlyserious.moreover,theformationofcollateralcirculationishelpfulforprotectionofthefunctionoftheventricle.Addition