CAJ | 학술논문

目的：研究汉族受检人群体重指数(BMI)与冠状动脉造影(CAG)检查辐射剂量面积乘积(DAP)值、透视时间相关性,早期判断和降低高辐射风险。方法回顾性分析451例汉族人群CAG患者资料,男276例,年龄32~87岁；女175例,年龄42~84岁；BMI值17.30~35.42 kg/m2。根据BMI值分为4组,A组25例(BMI＜20 kg/m2),B组204例(BMI 20~24.9 kg/m2),C组192例(BMI 25~29.9 kg/m2),D组30例(BMI＞30 kg/m2)。计算各组DAP和透视时间均值,采用非参数Kruskal-Wallis检验多重比较各组BMI患者DAP值,单因素方差分析或LSD-t检验比较各组BMI患者透视时间。结果 DAP均值在A组为(1070.07±541.33)μGy/m2,B组为(1326.82±606.91)μGy/m2,C组为(1937.99±1030.31)μGy/m2,D组为(2654.53±1296.69)μGy/m2；透视时间均值在A组为(3.53±2.08) min, B组为(2.70±1.80) min, C组为(2.75±1.88) min,D组为(2.71±1.69) min。组间比较,除A组与B组间DAP值差异无统计学意义(P=0.232),余各组间差异均有统计学意义(P＜0.05)；A组与其它各组间透视时间差异均有统计学意义(P＜0.05),余各组间差异均无统计学意义(P＞0.05)。结论成年汉族受检人群CAG手术中DAP值随BMI增高而增加,透视时间在BMI＜20 kg/m2时明显延长。介入手术中不仅要了解BMI增高造成DAP值增加,更需特别关注BMI＜20 kg/m2时手术难度提高所致透视时间延长造成的DAP值增加。
목적：연구한족수검인군체중지수(BMI)여관상동맥조영(CAG)검사복사제량면적승적(DAP)치、투시시간상관성,조기판단화강저고복사풍험。방법회고성분석451례한족인군CAG환자자료,남276례,년령32~87세；녀175례,년령42~84세；BMI치17.30~35.42 kg/m2。근거BMI치분위4조,A조25례(BMI＜20 kg/m2),B조204례(BMI 20~24.9 kg/m2),C조192례(BMI 25~29.9 kg/m2),D조30례(BMI＞30 kg/m2)。계산각조DAP화투시시간균치,채용비삼수Kruskal-Wallis검험다중비교각조BMI환자DAP치,단인소방차분석혹LSD-t검험비교각조BMI환자투시시간。결과 DAP균치재A조위(1070.07±541.33)μGy/m2,B조위(1326.82±606.91)μGy/m2,C조위(1937.99±1030.31)μGy/m2,D조위(2654.53±1296.69)μGy/m2；투시시간균치재A조위(3.53±2.08) min, B조위(2.70±1.80) min, C조위(2.75±1.88) min,D조위(2.71±1.69) min。조간비교,제A조여B조간DAP치차이무통계학의의(P=0.232),여각조간차이균유통계학의의(P＜0.05)；A조여기타각조간투시시간차이균유통계학의의(P＜0.05),여각조간차이균무통계학의의(P＞0.05)。결론성년한족수검인군CAG수술중DAP치수BMI증고이증가,투시시간재BMI＜20 kg/m2시명현연장。개입수술중불부요료해BMI증고조성DAP치증가,경수특별관주BMI＜20 kg/m2시수술난도제고소치투시시간연장조성적DAP치증가。
Objective To investigate the relationship between body mass index (BMI) and dose area product (DAP) as well as fluoroscopy time during coronary angiography (CAG) in Han nationality subjects in order to improve early judging and reducing high radiation risk. Methods CAG materials of 451 Han nationality subjects were retrospectively analyzed. The patients included 276 males (age 32-87 years) and 175 females (age 42-84 years), and the BMI values ranged from 17.30 to 35.42 kg/m2. According to BMI values, the patients were divided into group A(BMI<20 kg/m2,n=25), group B (BMI 20-24.9 kg/m2,n=204), group C (BMI 25-29.9 kg/m2,n=192) and group D (BMI>30 kg/m2,n=30). The mean DAP and fluoroscopy time of each group were calculated; the DAP values were compared between each other among the four groups by using nonparametric Kruskal-Wallis test, while the fluoroscopy time was compared between each other among the four groups by using single factor analysis of variance or LSD-t test. Results The mean DAP of group A, B, C and D was(1 070.07±541.33) μGym2,(1 326.82±606.91) μGym2,(1 937.99±1 030.31) μGym2 and (2 654.53±1 296.69) μGym2 respectively. The mean fluoroscopy time of group A, B, C and D was (3.53± 2.08) min, (2.70 ±1.80) min, (2.75 ±1.88) min and (2.71 ±1.69) min respectively. Statistically significant difference in DAP values existed between each other among the four groups (P<0.05) except between group A and group B (P=0.232). Statistically significant difference in fluoroscopy time existed between group A and other three groups (P<0.05), while the difference in fluoroscopy time between each other among B, C and D groups was not significant (P>0.05). Conclusion The DAP values of adult Han subjects receiving CAG are increased with the increase of BMI values; the fluoroscopy time is significantly prolonged in patients with BMI<20 kg/m2. In performing interventional procedure, the operator should not only understand that the increase of BMI can cause the increase of DAP, but also need to pay special attention to the increase of DAP value caused by operation difficulty when the patient’s BMI is <20 kg/m2.