CAJ | 학술논문

目的：通过64层螺旋CT冠状动脉成像，探讨隐匿型冠心病与心血管疾病危险因素的关系。方法收集南昌大学附属新余医院2012年1月-2014年1月行常规心电图或动态心电图检查、核素扫描提示心肌缺血而无临床症状的隐匿型冠心病患者80例。患者均行64层螺旋CT冠状动脉成像检查，同时记录患者性别、年龄、血压、体质指数（ BMI），检测患者空腹血糖、总胆固醇（ TC）、三酰甘油（ TG）、低密度脂蛋白胆固醇（ LDL-C）、高密度脂蛋白胆固醇（ HDL-C）、载脂蛋白A1（ Apo-A1）、载脂蛋白B100（ Apo-B100）和脂蛋白α（ LP-α）水平。对所有观察指标进行量化，分析隐匿型冠心病与心血管疾病危险因素的关系。结果80例隐匿型冠心病患者中轻度狭窄59例，中度狭窄21例。冠状动脉狭窄程度在不同年龄段及不同空腹血糖、TC、TG、LDL-C水平患者间差异有统计学意义（ P<0.05）。Logistic回归分析显示，高血糖〔OR=3.148，95%CI（1.457，6.712），P=0.003〕、TC≥6.45 mmol/L〔OR=2.368，95%CI（1.322，4.273），P=0.004〕、高血压〔OR=2.256，95%CI（1.173，4.337），P=0.014〕、年龄≥60岁〔OR=1.064，95%CI（1.027，1.110），P=0.000〕是隐匿型冠心病冠状动脉狭窄的独立危险因素。结论64层螺旋CT冠状动脉成像清晰显示隐匿型冠心病冠状动脉狭窄，且血糖、TC、高血压、年龄是隐匿型冠心病冠状动脉狭窄的影响因素，对早期诊断、防治隐匿型冠心病，减少急性冠状动脉事件的发生具有重要临床意义。
목적：통과64층라선CT관상동맥성상，탐토은닉형관심병여심혈관질병위험인소적관계。방법수집남창대학부속신여의원2012년1월-2014년1월행상규심전도혹동태심전도검사、핵소소묘제시심기결혈이무림상증상적은닉형관심병환자80례。환자균행64층라선CT관상동맥성상검사，동시기록환자성별、년령、혈압、체질지수（ BMI），검측환자공복혈당、총담고순（ TC）、삼선감유（ TG）、저밀도지단백담고순（ LDL-C）、고밀도지단백담고순（ HDL-C）、재지단백A1（ Apo-A1）、재지단백B100（ Apo-B100）화지단백α（ LP-α）수평。대소유관찰지표진행양화，분석은닉형관심병여심혈관질병위험인소적관계。결과80례은닉형관심병환자중경도협착59례，중도협착21례。관상동맥협착정도재불동년령단급불동공복혈당、TC、TG、LDL-C수평환자간차이유통계학의의（ P<0.05）。Logistic회귀분석현시，고혈당〔OR=3.148，95%CI（1.457，6.712），P=0.003〕、TC≥6.45 mmol/L〔OR=2.368，95%CI（1.322，4.273），P=0.004〕、고혈압〔OR=2.256，95%CI（1.173，4.337），P=0.014〕、년령≥60세〔OR=1.064，95%CI（1.027，1.110），P=0.000〕시은닉형관심병관상동맥협착적독립위험인소。결론64층라선CT관상동맥성상청석현시은닉형관심병관상동맥협착，차혈당、TC、고혈압、년령시은닉형관심병관상동맥협착적영향인소，대조기진단、방치은닉형관심병，감소급성관상동맥사건적발생구유중요림상의의。
Objective To investigate the relationship of latent coronary heart disease( LCHD)to the risk factors of cardiovascular diseases(CVD)using 64-slice spiral CT coronary angiography(CTA). Methods It gave CTA to 80 LCHD patients who had conventional electrocardiogram or Holter monitoring,radionuclide scanning in Affiliated Xinyu Hospital of Nan-chang University from January 2012 to January 2014,recorded their gender,age,blood pressure,BMI,and determine their levels of fasting blood glucose( FBG),total cholesterol( TC),triglyceride( TG),low density lipoprotein cholesterol( LDL-C),high density lipoprotein cholesterol( HDL-C),apolipoprotein A1 ( Apo-A1 ),apolipoprotein B100 ( Apo-A100 )and lipoproteinα( LP-α). It quantified all observed indicators to analyze the relationship of LCHD to CVD risk factors. Results In 80 LCHD patients,there were 59 cases of mild stenosis,21 of moderate stenosis. There were significant differences in the de-gree of coronary artery stenosis in different ages and different fasting plasma glucose,TC,TG,LDL-C levels(P<0. 05). Logistic regression analysis showed:high blood glucose〔OR =3. 148,95%CI(1. 457,6. 712),P =0. 003〕,TC≥6. 45 mmol/L〔OR=2. 368,95%CI(1. 322,4. 273),P=0. 004〕,hypertension〔OR=2. 256,95%CI(1. 173,4. 337),P=0. 014〕,age≥60 years〔OR=1. 064,95%CI(1. 027,1. 110),P=0. 000〕were more closely correlated with the degree of CAS. Conclusion 64-slice CTA can reveal LCHD CAS clearly,and glucose,TC,high blood pressure,age is narrow oc-cult factors coronary,which is of great clinical significance in its early diagnosis and treatment and in reducing the occurrence of acute coronary events.