CAJ | 학술논문

目的评价冠状动脉(冠脉)钙化积分(CACS)的相关因素.方法入选疑诊冠心病的患者141例,3个月内完成多层螺旋CT、脉搏波传导速度(PWV)、超声心动图及血生化检查,MDRD方程计算患者入院时估算肾小球滤过率(eGFR).根据冠脉钙化程度将病例分为3组:A组(CACS=0～10),B组(CACS=11～400),C组(CACS>400).结果 3组比较年龄、高血压病史、糖尿病史、二尖瓣钙化、主动脉瓣钙化、两侧臂踝指数低值、臂到踝的PWV高值、臂及踝平均动脉压高值、波形上升支时间高值差异均有统计学意义(P值均<0.05).多因素logistic回归分析显示:主动脉瓣钙化(P=0.000)、二尖瓣钙化(P=0.002)、波形上升支时间高值(P=0.009)和糖尿病(P=0.032)是严重冠脉钙化的独立相关因素.结论疑诊冠心病的患者行多层螺旋CT检查前可行PWV和超声心动图检查,结合病史评估患者冠脉钙化的可能性及严重程度.
목적 평개관상동맥(관맥)개화적분(CACS)적상관인소.방법 입선의진관심병적환자141례,3개월내완성다층라선CT、맥박파전도속도(PWV)、초성심동도급혈생화검사,MDRD방정계산환자입원시고산신소구려과솔(eGFR).근거관맥개화정도장병례분위3조:A조(CACS=0～10),B조(CACS=11～400),C조(CACS>400).결과 3조비교년령、고혈압병사、당뇨병사、이첨판개화、주동맥판개화、량측비과지수저치、비도과적PWV고치、비급과평균동맥압고치、파형상승지시간고치차이균유통계학의의(P치균<0.05).다인소logistic회귀분석현시:주동맥판개화(P=0.000)、이첨판개화(P=0.002)、파형상승지시간고치(P=0.009)화당뇨병(P=0.032)시엄중관맥개화적독립상관인소.결론 의진관심병적환자행다층라선CT검사전가행PWV화초성심동도검사,결합병사평고환자관맥개화적가능성급엄중정도.
Objective To evaluate the correlating clinical factors of coronary artery calcification score(CACS).Methods 141 patients suspected of coronary artery disease were included.They underwent multi-slice row computed tomography,pulse wave velocity ( PWV ),UCG and blood biochemistry within a period of 3 months.The subjects were divided into three groups according to CAC score:A(CACS =0-10),B ( CACS = 11-400),C ( CACS > 400).Results CACS was significantly associated with age,history of hypertension and diabetes mellitus.It was also associated with the presence of mitral annular calcification and aortic valve calcification,low ankel brachial pressure index(ABI) and high mean artery pressure(MAP) as well as high values of brachial ankel PWV (baPWV) and Upstroke time (UT).Muhifactorial logistic regression analysis showed that the presence of aortic valve calcification and mitral annular calcification,the history of diabetes mellitus and high value of UT were independently correlated with severe coronary artery calcification.Conclusions Aortic valve calcification,mitral annular calcification,history of diabetes mellitus,high value of UT were independently correlated with severe coronary artery calcification.Measurement of PWV and UCG should be performed before muhi-slicerow computed tomography,because the assessment of coronary artery lumen narrowing with multi-slice row computed tomography can not be carried out accurately in the presence of severe coronary artery calcification.