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目的:探讨冠状动脉CT血管造影对冠状动脉粥样硬化性心脏病(冠心病，CHD)患者斑块类型及性质的诊断价值。方法:回顾性分析2016年1月至2018年12月杭州市红十字会医院收治的冠心病患者80例的临床资料，根据斑块的CT值分为钙化斑块组(CT值≥130 HU)20例、软斑块组(CT值≤60 HU)20例、混合斑块组(CT值60～130 HU)40例。对比分析三组患者的冠脉狭窄程度与斑块类型的关联、血小板功能和血清生化和脂肪细胞因子指标差异。结果:不同类型的斑块与狭窄程度的比例存在一定关联，钙化斑块组轻度狭窄12例，中度狭窄5例，重度狭窄3例；混合斑块组轻度狭窄11例，中度狭窄14例，重度狭窄15例；软斑块组轻度狭窄2例，中度狭窄7例，重度狭窄11例，差异有统计学意义(χn 2＝13.27，n P0.05)；钙化斑块组、混合斑块组和软斑块组比较，血小板衍生生长因子BB(PDGF-BB)、血栓最大坚固度(TEG-MA)和P选择素(P-selectin)，软斑块组高于混合斑块组且高于钙化斑块组，差异均有统计学意义(n F＝11.57、6.47、18.74，均n P<0.05)。血清学指标和脂肪细胞因子比较，钙化斑块组、混合斑块组和软斑块组比较，C反应蛋白(CRP)、白细胞介素6(IL-6)、白细胞介素12(IL-12)、瘦素(Leptin)和分泌型卷曲相关蛋白5(SFRP5)，软斑块组高于混合斑块组且高于钙化斑块组，差异均有统计学意义(n F＝7.95、21.31、14.58、9.37、13.58，均n P<0.05)。n 结论:冠状动脉血管造影对冠心病患者可通过评估斑块的类型从而判断冠心病病情严重程度，为临床制定治疗方案提供理论依据，值得临床推广。“,”Objective:To investigate the diagnostic value of plaque type and nature of coronary artery angiography in patients with coronary heart disease.Methods:The clinical data of 80 patients with coronary heart disease in Hangzhou Red Cross Hospital were retrospectively analyzed.According to the CT value of plaque, 20 cases were classified into calcified plaque group (CT value ≥130 HU) and soft plaque group (CT value ≤60 HU). Mixed plaque group (CT value 60-130 HU) had 40 cases.The association between coronary stenosis and plaque type, platelet function, serum biochemical and adipocytokine indicators were compared among the three groups.Results:There was a certain correlation between the proportion of different types of plaque and the degree of stenosis.There were 12 cases of mild stenosis, 3 cases of moderate stenosis and 5 cases of severe stenosis in calcified plaque group, 11 cases of mild stenosis, 14 cases of moderate stenosis and 15 cases of severe stenosis in mixed plaque group, 2 cases of mild stenosis, 7 cases of moderate stenosis and 11 cases of severe stenosis in soft tissue plaque group, the difference was statistically significant (χn 2=13.27, n P0.05). The PDGF-BB, TEG-MA and P-selectin levels in the soft tissue plaque group were higher than those in the mixed plaque group and the calcified plaque group, the differences were statistically significant (n F=11.57, 6.47, 18.74, all n P<0.05). As to the adipose cytokines, the levels of CRP, IL-6, IL-12, leptin and SFRP5 in the soft tissue plaque group were higher than those in the mixed plaque group and the calcified plaque group, the differences were statistically significant(n F=7.95, 21.31, 14.58, 9.37, 13.58, all n P<0.05).n Conclusion:Coronary CT angiography can evaluate the severity of coronary heart disease by evaluating the type of plaque, and provide a theoretical basis for clinical treatment.It is worthy of clinical promotion.