双源CT评价代谢综合征患者冠状动脉病变的临床研究

目的:研究双源CT冠脉造影评估伴或不伴代谢综合征(MS)患者冠状动脉病变的效果。方法:74例拟诊为冠心病患者被分为MS组(26例)和非MS组(48例),在传统的冠脉造影前,使用双源CT血管造影评估冠脉钙化积分,同时定量评估冠脉显著狭窄程度和不同性质的冠脉粥样硬化斑块数目。结果:MS组患者冠脉显著狭窄的血管支数明显高于非MS组[(2.27±0.92)支:(1.46±1.20)支,P0.005]。两组患者间的钙化积分无显著性差异(P0.05)。非参数检验显示两组患者的钙化斑块[MS组144个(5.54个/例),非MS组140个(2.91个/例)和软斑块[MS组134个(5.15个/例),非MS组109个(2.27个/例]有显著性差异(钙化斑块,P0.05;软斑块,P0.005)。多元回归分析显示MS与软斑块独立相关(OR=1.44,P=0.028)。结论:在伴代谢综合征的患者中,冠状动脉显著狭窄的血管支数、钙化斑块和软斑块发病率升高,提示代谢异常可以增加冠脉斑块和斑块的易损性。

Study of evaluating coronary lesions by dual-source computed tomography in patients with metabolic syndrome

Objective：To investigate the results evaluating coronary lesions by dual-source computed tomography（DSCT）in patients with metabolic syndrome（MS）.Methods：A total of 74 patients planned to diagnose as coronary heart disease were divided into two groups：MS group（n=26） and non-MS group（n=48）.DSCT coronary angiography combined with coronary calcium scoring was performed before conventional coronary angiography for all 74 patients.Significantly stenotic（≥50%） vessels and the number of different types of plaque were quantified for statistical analysis.Results：The number of significantly stenotic vessels in MS group was significantly more than that of non-MS group [（2.27±0.92） vs.（1.46±1.20）,P〈0.005].There was no significant difference in calcium scoring between the two groups（P〉0.05）.Nonparametric test revealed that the numbers of calcified and soft plaque were significantly more than those of non-MS group [calcified plaque：144（5.54/case） vs.140（2.91/case）,P〈0.05;soft plaque：134（5.15/case）vs.109（2.27/case）,P〈0.005）.Multivariable logistic regression analysis showed that MS independently associated with soft plaque（OR=1.44,P=0.028）.Conclusion：In patients with coronary heart disease and metabolic syndrome,they are more likely to have more number of significantly stenotic vessels,calcified and soft plague.It reveals that metabolic dysfunction can increase coronary lesion and vulnerability of plague.