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Methods Sequence specific primers-polymerase chain reaction was used for the detection of genotypes and alleles of rs3850641 A/G loci in OX40L gene in 187 PACS cases (≤55 years) and 138 controls. Diseased vessel numbers and stenostic severity integral by coronary arteriogram and serum levels of sOX40L, C-reactive protein and vascular cell adhesion molecule-1 (VCAM-1) by enzyme-linked immunosorbent assay and nephelometry were measured. The relationship between OX4OL gene variants and PACS risk, SSI as well as plasma levels of three cytokines were analysed.

采用聚合酶链反应-序列特异性扩增技术检测187例年龄≤55岁、早发急性冠状动脉综合征患者和138例冠状动脉造影正常者rs3850641位点A/G变异的基因型、等位基因及其分布频率;采用冠状动脉造影测量病变血管支数和狭窄程度积分;应用ELISA法测试血浆sOX40L、血管细胞黏附分子(VCAM-1);应用散射比浊法测试血浆C反应蛋白水平;分析OX40L基因变异与ACS风险、冠状动脉病变程度和血浆3个细胞因子之间的关系。

Its coincidence rate with CAG was 89% in left coronary artery main stem, 93% in left anterior descending coronary artery, 68% in left circumflex coronary artery, and 48% in right coronary artery.

64排螺旋CT冠状动脉成像能较准确反应各支血管部位的狭窄程度,对左主干及前降支病变与冠状动脉造影检查符合率较高,在评价冠状动脉狭窄、定性和定量检测冠状动脉粥样硬化斑块等方面都有良好的临床应用价值。

Methods: In this series,coronary heart disease was proven by clinic,electrocardiogram and selective coronary arteriography.Causes of 30 cases of PICAS were acute coronary occlusion in PTCA (2 cases),coronary arterial dissection (1 cases),preventing coronary arterial restenosis after PTCA (18 cases),coronary arterial restenosis after PTCA (4 cases) and acute myocardial infarction (5 cases).Thirty cases of SCAG were performed by Judkins method.

材料和方法:本组病例均经临床,心电图和选择性冠状动脉造影证实为冠心病。30例经皮冠状动脉内支架植入术的原因有经皮腔内冠状动脉成形术中发生急性冠状动脉闭塞2例,冠状动脉夹层1例,为防止PTCA术后再狭窄18例,PTCA术后再狭窄4例,急性心肌梗塞5例。30例SCAG均采用Judkins法。

Accuracy between two groups was calculated byχ~2 test.Calculate the average effective radiation dose of the 30 patients.Results In group A,seventeen patients underwent both DSCT coronary angiography and SCAG,among 255 segments of 17 patients,105 lesion sites of 70 segments were diagnosed stenosis or obstruction,of them,95 lesion sites were confirmed by SCAG.The accuracy of DSCTCA was 90.48%.The agreement of two methods have a high agreement(Kappa =0.853).In group B,13 patients underwent both DSCT coronary angiography and SCAG,among 195 segments of 13 patients,73 lesion sites of 57 segments were diagnosed stenosis or obstruction, of them,65 lesion sites were confirmed by SCAG.The accuracy of DSCTCA was 89.04%.The agreement of two methods have a high agreement(Kappa =0.835). There was no significant difference(χ~2=0.098,p>0.05) between the accuracy of two groups.The effective radiation dose of 30 patients was 3.67±0.43 mSv.Conclusion Compared with SCAG,prospectively ECG-gated transverse DSCT is a valuable examination to detect and diagnose coronary artery disease with a low dose coronary angiography.The accuracy of the DSCT is approximate to the SCAG.There was no significant difference between the accuracy of two groups.

结果200例患者均成功完成了适应性前瞻性心电门控双源CT冠状动脉血管成像;30例同期行SCAG检查的患者,A组17例:HR≤75 bpm,可评价冠状动脉节段255个,70个冠状动脉节段有105处不同程度的狭窄,95处狭窄程度与金标准SCAG相符,其阳性诊断准确率为90.48%;2种方法的诊断结果得到了较高的一致性(Kappa值=0.853)。B组13例;HR≥91 bpm,可评价冠状动脉节段195个,57个冠状动脉节段有73处不同程度的狭窄,65处狭窄程度与SCAG相符,其阳性诊断准确率为89.04%;2种方法的诊断结果得到了较高的一致性(Kappa值=0.835)。2个心率组间的诊断准确率无明显统计学差异(x~2=0.098,p>0.05)。30例患者的平均有效辐射剂量为3.67±0.43 mSv结论适应性前瞻性心电门控双源CT冠状动脉成像是一种有效减低辐射剂量的扫描方式,其诊断准确率与金标准SCAG相比得到较高的一致性,且高、低2个心率组间诊断准确率无明显统计学差异。

Objectives: The most frequent anatomicopathological phenomenon in the early hours of the acute myocardial infarction is the total occlusion of the culprit coronary artery.

目的 急性心肌梗死( acute myocardial infarction,AMI)早期最显而易见的病理解剖学现象为冠状动脉的完全闭塞,所以,既往人们的研究兴趣以及治疗策略大多集中于心外膜下的闭塞冠脉,并且已有多种成熟应用于临床的闭塞冠脉血运重建措施。

Results Compared with percutaneous coronary angiography,the sensitivity of sixteen slice sparil CT in diagnosing moderate and severe coronary stenosis was 83.33%,and the specificness,positive predictive value,negative predictive value and degree of accuracy was 91.40%,85.59%,89.95% and 83.33% respectively.

对16层螺旋CT显示冠状动脉狭窄和经皮选择性冠状动脉造影显示冠状动脉狭窄进行定量评价。以经皮选择性冠状动脉造影结果作为诊断的金标准。计算出16层螺旋CT冠状动脉成像对冠状动脉狭窄的诊断准确性指标。

Results Compared with percutaneous coronary angiography,the sensitivity of sixteen slice sparil CT in diagnosing moderate and severe coronary stenosis was 83.33%,and the specificness,positive predictive value,negative predictive value and degree of accuracy was 91.40%,85.59%,89.95% and 83.33% respectively.

计算 出16层螺旋CT冠状动脉成像对冠状动脉狭窄的诊断准确性指标。结果 16层螺旋CT冠状动脉造影对照经皮选择性冠状动脉造影对冠状动脉中、重度狭窄显示的对照结果:敏感性83.33%、特异性91.40%、阳性预测值85.59%、阴性预测值89.95%、准确度83.33%。

Results Compared with percutaneous coronary angiography,the sensitivity of sixteen slice sparil CT in diagnosing moderate and severe coronary stenosis was 83.05%,and the specificness,positive predictive value,negative predictive value and degree of accuracy was 95.97%,89.09%,93.46% and 92.31% respectively.

结果 16层螺旋CT冠状动脉造影对照经皮选择性冠状动脉造影对冠状动脉中、重度狭窄显示的对照结果:敏感性83.05%、特异性95.97%、阳性预测值89.09%、阴性预测值93.46%、准确度92.31%。结论 16层螺旋CT冠状动脉造影对心电图正常的胸痛患者具有良好的诊断价值,并可对冠状动脉形态学进行良好的评价,从而进行介入治疗的筛选。

objective inquire into the value of eet and cag in the diagnose of coronary heart disease.methods review and analyze132cases of positive eet and77cases of results of cag.results positive cag:58cases(75%);negative cag:19cases(25%);single-branch pathology18cases;double-branch pathologies:40cases;many-branch pathologies:19cases;stc extension:25cases;s-wave deepeness:21cases;u-wave inverˉsion:2cases.conclusion among the patients of eet,dangerous factors conform to the results of cag inclinical symptom relatively,among females,young people and non-clinical symptom,false positiveness is more.

目的 探讨活动平板运动试验与冠状动脉造影在冠心病诊断中的价值。方法对132例活动平板运动试验阳性,77例冠状动脉造影结果进行回顾性分析。结果冠状动脉造影阳性58例(75%),阴性19例(25%),单支病变18例,双支病变40例,多支病变19例,stc延长25例,s波加深21例,u波倒置2例。结论在活动平板运动试验患者中,有危险因素和临床症状与冠状动脉造影结果较相符,女性、年轻人和无临床症状者假阳性较多。

METHODS: Left coronary artery, mural coronary artery proximal end, mural coronary artery and mural coronary artery distal end of 10 patients with coronary artery bypass grafting were treated with heparin-saline and 4% glutaral.

用肝素-生理盐水和4%戊二醛溶液常规处理10例心肌桥冠脉搭桥术患者切除的左冠状动脉,取壁冠状动脉近段、壁冠状动脉段、壁冠状动脉远段,扫描电镜观察其血管内皮细胞和基膜特征。

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