[1]许方雷,罗雪挺.CT心肌灌注成像参数对ST段抬高型心肌梗死再血管化治疗患者微循环梗阻的评估价值分析[J].介入放射学杂志,2026,(08):891-897.[doi:10.3969/j.issn.1008-794X.2026.08.011]
 XU Fanglei,LUO Xueting..Application of CT myocardial perfusion imaging parameters in evaluating microvascular obstruction in patients with ST-segment elevation myocardial infarction receiving revascularization therapy[J].J Intervent Med,2026,(08):891-897.[doi:10.3969/j.issn.1008-794X.2026.08.011]
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CT心肌灌注成像参数对ST段抬高型心肌梗死再血管化治疗患者微循环梗阻的评估价值分析()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2026年08
页码:
891-897
栏目:
临床研究
出版日期:
2026-08-12

文章信息/Info

Title:
Application of CT myocardial perfusion imaging parameters in evaluating microvascular obstruction in patients with ST-segment elevation myocardial infarction receiving revascularization therapy
文章编号:
1008-794X(2026)-008-0891-07
作者:
许方雷 罗雪挺
430000 湖北武汉 湖北省中医院/湖北省中医药研究院/湖北中医药大学附属医院心病科(心血管内科)
Author(s):
XU FangleiLUO Xueting.
Department of Cardiovascular Medicine,Affiliated Hospital of Hubei Provincial Hospital of Traditional Chinese Medicine/Hubei Provincial Institute of Traditional Chinese Medicine/Hubei University of Traditional Chinese Medicine,Wuhan,Hubei Province 430000,China
关键词:
ST段抬高型心肌梗死 CT心肌灌注成像 再血管化治疗 微循环梗阻
分类号:
R445.3
DOI:
10.3969/j.issn.1008-794X.2026.08.011
文献标志码:
B
摘要:
目的 探究CT心肌灌注成像(CT myocardial perfusion imaging,CT-MPI)参数对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)再血管化治疗患者微循环梗阻(microcirculatory obstruction,MVO)的评估价值分析。方法 纳入2021年7月至2025年7月湖北省中医院接收的200例成功接受再血管化治疗STEMI患者。所有患者均接受磁共振检成像(MRI)检查,根据延迟钆增强评估是否发生MVO分为MVO组(n=120)与非MVO组(n=80),对比2组基线资料、临床指标及CT-MPI参数[心肌血流量(myocardial blood flow,MBF)、心肌血容量(myocardial blood volume,MBV)、血管外容积、达峰时间、组织通过时间]差异,采用Pearson相关分析基线资料与CT-MPI参数相关性,采用二元logistic回归分析影响STEMI患者是否出现MVO的独立影响因素,并采用ROC曲线分析相关CT-MPI参数对MVO的预测价值。结果 MVO组术前TIMI血流0~1级占比、LVEDV、LVESV、CRP均高于非MVO组(P<0.05),LVEF低于非MVO组(P<0.05); MVO组MBF、MBV均低于非MVO组(P<0.05),血管外容积高于非MVO组(P<0.05),两组达到峰值时间、组织通过时间差异无统计学意义(P>0.05)。Pearson相关分析显示,MBF、MBV与LVEF呈显著正相关(P<0.05),与LVEDV、LVESV、CRP呈显著负相关(P<0.05); 血管外容积与LVEF呈显著负相关(P<0.05),与LVEDV、LVESV、CRP呈显著正相关(P<0.05)。术前TIMI血流0~1级、LVEF、CRP、MBF、MBV、血管外容积均是STEMI再血管化治疗患者MVO的影响因素(P<0.05); MBF、MBV、血管外容积为检验变量,预测MVO的AUC为0.713、0.812、0.751,联合预测AUC为0.885,预测价值更高。结论 CT-MPI参数对STEMI再血管化治疗患者发生MVO具有一定评估价值,其中MBF、MBV下降、血管外容积升高与STEMI患者发生MVO相关,可作为临床参考。

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(收稿日期:2025-12-26)
(本文编辑:元 禾)

备注/Memo

备注/Memo:
通信作者: 罗雪挺 E-mail:thanks_l@sina.com
更新日期/Last Update: 2026-08-25