冠状动脉钙化积分相关临床因素分析

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.

An analysis of clinical factors for coronary artery calcification score

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.