多层螺旋CT评价主动脉瓣钙化与冠状动脉斑块性质相关性研究

目的 探讨256层iCT评价主动脉瓣钙化（AVC）与冠状动脉斑块性质的相关性。方法 收集可疑冠状动脉性心脏病患者223例，行冠状动脉CTA（CCTA）。根据有无AVC将患者分为AVC组（n=55）和对照组（n=168），将冠状动脉斑块分为钙化斑块（CP）、非钙化斑块（NCP）、混合斑块（MP），并进行统计学分析。结果 AVC组与对照组CP、MP检出率、严重狭窄发生率、冠状动脉钙化积分和冠状动脉病变节段数的差异均有统计学意义（P均<0.05），而NCP检出率和多支血管病变发生率差异均无统计学意义（P均>0.05）。Logistic回归分析显示AVC与CP、MP、多支病变和严重狭窄的发生均存在独立相关性（OR=3.53、3.51、3.13、5.80，95%CI:1.66~7.50、1.59~7.79、1.45~6.77、2.30~14.60，P均<0.05），而与NCP的发生无相关性（P>0.05）。结论 AVC与冠状动脉CP和MP的发生独立相关，且AVC的出现多提示冠状动脉病变累及范围更广、更严重。

Correlation study of aortic valve calcification and coronary plaque character by multi-slice spiral CT

Objective To explore 256-row iCT in evaluation of correlation of aortic valve calcification (AVC) and coronary plaque character. Methods Totally 223 patients who were suspected coronary artery disease were enrolled, and coronary CTA (CCTA) was performed. Patients were divided into AVC group (n=55) and control group (n=168) according to if there was AVC. Coronary plaque was clarified into 3 types:Calcified plaque (CP), non-calcified plaque (NCP), mixed plaque (MP). Statistical analysis was carried out. Results Compared to control group, detection rate of CP, MP, occurrence rate of severe stenosis, coronary artery calcium scoring and segment number of coronary artery disease in AVC group were significant higher (all P<0.05), but there were no significant difference in detection rate of NCP and multi-vessels disease (all P>0.05). Logistic regression analysis showed that AVC was independently correlate with the occurrence of CP, MP, multi-vessels disease and severe stenosis (OR=3.53, 3.51, 3.13, 5.80; 95%CI:1.66-7.50, 1.59-7.79, 1.45-6.77, 2.30-14.6; all P<0.05), but there was no correlation with the occurrence of NCP (P>0.05). Conclusion AVC is independently correlated with occurrence of CP and MP. Once AVC has occurred, it often predicts more broader and severe coronary heart disease.