肺癌低剂量CT筛查者冠状动脉钙化检出率及危险因素分析

发布时间：2018-01-30 20:56

本文关键词： 冠状动脉钙化钙化积分视觉评分危险因素肺癌筛查低剂量CT　出处：《中国动脉硬化杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的探讨肺癌低剂量CT筛查人群中冠状动脉钙化检出率及相关危险因素。方法选取2013至2016年首次在我院行肺癌低剂量CT筛查的40岁以上无症状男性2722例,年龄40~81岁,其中吸烟者1052例,非吸烟者1670例。收集相关病史及血液生化检查资料,包括年龄、体质指数、吸烟史、糖尿病史及血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血尿酸、血肌酐。采用视觉评分方法进行冠状动脉钙化评分。对不同人群钙化检出率差异进行χ2检验;冠状动脉钙化与危险因素的分析采用Spearman相关分析及多因素Logistic回归。结果 2722例中,发生冠状动脉钙化者642例(23.6%),其中轻、中、重度钙化分别占88.8%、8.9%、2.3%,平均年龄为56.7±9.8岁;无冠状动脉钙化者2080例,平均年龄为49.5±7.1岁。吸烟组冠状动脉钙化检出率高于非吸烟组(25.9%比22.2%,P=0.027)。冠状动脉钙化与年龄、吸烟、高血脂、糖尿病、血肌酐升高呈显著相关,与高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸升高无显著关联。随着年龄增长,钙化检出率逐渐增加;50岁以下者,吸烟组的钙化检出率是非吸烟组的2倍多。结论无症状肺癌低剂量CT筛查人群中,轻度冠状动脉钙化检出率较高;年龄、吸烟、高血脂、糖尿病、血肌酐升高是冠状动脉钙化的危险因素。
[Abstract]:Objective to investigate the detection rate of coronary artery calcification and related risk factors in low dose CT screening population of lung cancer. Methods from 2013 to 2016, the patients over 40 years old who underwent low dose CT screening for lung cancer in our hospital for the first time from 2013 to 2016 were selected. Male 2722 cases. There were 1052 smokers and 1670 non-smokers. The relevant medical history and blood biochemical examination data including age body mass index smoking history diabetes history and blood glucose were collected. Total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, uric acid. Serum creatinine. Coronary artery calcification score was evaluated by visual scoring method. 蠂 2 test was used to test the difference of calcification detection rate in different population. Coronary artery calcification and risk factors were analyzed by Spearman correlation analysis and multivariate Logistic regression. There were 642 cases with coronary artery calcification, of which mild, moderate and severe calcification accounted for 88.88.9and 2.3, with an average age of 56.7 卤9.8 years. There were 2 080 cases without coronary artery calcification (mean age 49.5 卤7.1 years). The positive rate of coronary artery calcification in smoking group was higher than that in non-smoking group (25.9% vs 22.2%). Coronary artery calcification was significantly correlated with age, smoking, hyperlipidemia, diabetes and creatinine levels, and was associated with high density lipoprotein cholesterol and low density lipoprotein cholesterol. There was no significant correlation between the increase of uric acid and the rate of calcification. The detection rate of calcification in smoking group was twice as high as that in non-smoking group. Conclusion the detection rate of coronary artery calcification in low dose CT screening population of asymptomatic lung cancer is higher than that in non-smoking group. Age, smoking, hyperlipidemia, diabetes, and elevated serum creatinine were risk factors for coronary artery calcification.
【作者单位】：中山大学附属第五医院放射科;
【基金】：广东省科技厅项目(2009B030801120)
【分类号】：R541.4;R730.44;R734.2
【正文快照】： 近年来,我国冠心病的发病率呈明显上升趋势,早期发现冠心病具有重要意义。冠状动脉钙化(coronary artery calcification,CAC)作为冠心病的基本病变之一,能够反映冠心病的严重程度,冠状动脉钙化程度与患者发生心肌梗死和心源性猝死的危险性呈正相关[1];目前临床上可通过CT检查

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