目的 探讨缺血性脑病（Ischemic Cerebral Vascular Disease，ICVD）评分中低风险度无典型冠心病症状者冠状动脉病 变的发生情况。方法 2016年8月至2017年5月连续506例无典型冠心病临床症状、ICVD中低风险度399例，计算中低风险度 组斑块以及≥50%狭窄的检出率，对比低风险度组与中等风险度组斑块及≥50%狭窄的检出率，并对比中低风险度组各类 斑块的检出率。结果 399例中斑块检出率为57.6%（230/399），≥50%粥样硬化性狭窄检出率为20.6%（82/399）。低、中 等风险组斑块的检出率分别为55.4%（180/325）、67.6%（50/74），低、中等风险组≥50%狭窄病变的检出率分别为20.9% （68/325）、18.9%（14/74），其之间均无统计学差异。低、中等风险度组非钙化斑块、钙化斑块及混合斑块的检出率均 无统计学差异。结论 本研究表明，无典型冠心病症状的ICVD中低风险度者，具有较高的冠状动脉斑块及冠状动脉狭窄的 检出率。256层螺旋CT是检出冠状动脉斑块及狭窄以便及早进行医疗干预的有效手段。

Objective To investigate the incidence of coronary artery disease in patients with low risk and without typical coronary heart disease (CHD) with ischemic cerebral vascular disease (ICVD) score. Methods From August 2016 to May 2017, we selected 506 consecutive patients with coronary heart disease without typical clinical symptoms and 399 cases of ICVD of low risk for analysis. The detection rate in both low risk group and more than 50% stenosis plaque group were calculated and compared. Results The plaque detection rate was 57.6% (230/399=50%) in the 399 cases. The detection rate of more than 50% atherosclerotic stenosis was 20.6% (82/399). the detection rates in low risk group and moderate plaque were 55.4% (180/325) and 67.6% (50/74), respectively. The more than 50% stenosis detection rate in low risk group and moderate plaque were 20.9% (68/325) and 18.9% (14/74), with no statistical difference. The detection rate of non-calcified plaques, calcified plaques and mixed plaques in low and moderate risk groups showed no difference. Conclusion The prevalence of coronary plaque and coronary stenosis is high in patients with low risk of coronary artery disease (ICVD) without typical coronary heart disease. The 256 layers of DCTCA is an effective means of detecting coronary plaque and stenosis for early medical intervention.