冠状动脉CT与冠心病危险因素的相关分析

发布时间：2018-01-24 12:42

本文关键词： 危险因素冠心病多排螺旋CT　出处：《南方医科大学学报》2012年10期 　论文类型：期刊论文

【摘要】：目的 Framingham计分是公认的估计心血管风险的方法,但是其预测的准确性一直有争论。冠脉CT诊断斑块有很高的准确性,本研究拟将冠脉CT斑块与Framingham危险因素进行对照研究,分析各危险因素预测冠脉斑块的准确性。方法连续入选核医学科2008年6月~2011年4月行64排螺旋CT的门诊和住院病人共706例。冠脉CT病变严重程度分为正常、轻度、中度、重度、支架或搭桥术后5类,将冠心病危险因素与冠脉CT进行相关分析,包括方差分析,Pearson相关和ROC曲线分析。结果正常冠脉CT占40.37%,异常冠脉CT占58.63%。高龄,高血压、高血脂症、糖尿病、临床诊断脑梗死、冠心病,心肌梗死患者冠脉CT斑块的比率明显高于正常冠脉CT组,差异显著,而且发生率随着病变程度加重而升高(P0.05)。临床诊断为冠心病的患者,冠脉CT正常22.5%,而冠脉CT异常77.5,差异显著(P0.05)。总胆固醇、低密度脂蛋白、高密度脂蛋白、尿素、肌酐与冠脉CT斑块明显相关,差异显著(P0.05)。甘油三酯,尿素氮,尿蛋白,尿酸,空腹血糖,全血糖化血红蛋白,血红蛋白,血清肌钙蛋白T,左室舒张末内径,左室射血分数等危险因素与冠脉斑块不相关(P0.05)。Pearson相关显示,危险因素与斑块相关。ROC曲线可见Framingham计分,肌酐,同型半胱氨酸和颈动脉内膜厚度预测冠脉斑块的准确性较高(P0.05)。结论冠心病危险因素与冠脉CT斑块明显相关,其中Framingham积分、肌酐、同型半胱氨酸和颈动脉内膜厚度相关最为密切,可以作为冠心病的一般筛查。
[Abstract]:Objective Framingham scoring is a recognized method for estimating cardiovascular risk, but the accuracy of its prediction has been disputed. Coronary CT diagnosis of plaque has a high accuracy. The aim of this study was to compare the risk factors of coronary CT plaque with Framingham. Methods A total of 706 outpatients and inpatients who underwent 64-slice spiral CT from June 2008 to April 2011 were enrolled in the department of nuclear medicine to evaluate the accuracy of predicting coronary plaque. The severity is divided into normal. The risk factors of coronary artery disease (CHD) were correlated with coronary CT, including analysis of variance (ANOVA). Results normal coronary CT accounted for 40.37%, abnormal coronary CT 58.63%. Old age, hypertension, hyperlipidemia, diabetes mellitus. The ratio of coronary artery CT plaque in patients with cerebral infarction, coronary heart disease and myocardial infarction was significantly higher than that in normal coronary CT group. The incidence of coronary CT was 22. 5 normal in patients with coronary heart disease and abnormal 77.5 in coronary CT. Total cholesterol, low density lipoprotein, high density lipoprotein, urea and creatinine were significantly correlated with coronary CT plaques. Urine protein, uric acid, fasting blood glucose, whole blood glycosylated hemoglobin, hemoglobin, serum troponin T, left ventricular end-diastolic diameter. Left ventricular ejection fraction (LVEF) and other risk factors were not associated with coronary plaque (P0.05N). Pearson correlation showed that the correlation between risk factors and plaque. ROC curve showed Framingham score. Creatinine, homocysteine and carotid intimal thickness were more accurate in predicting coronary plaque (P 0.05). Conclusion Coronary heart disease risk factors are significantly correlated with coronary artery CT plaque. Framingham scores, creatinine, homocysteine and carotid intima thickness are most closely related, and can be used as a general screening for coronary heart disease.
【作者单位】：解放军总医院心内科;解放军总医院核医学科;
【基金】：国家自然科学基金(30872204,30400367,81071378) 国家十一五科技支撑计划(2006BAI01A02) 国家留学基金(留金发[2010]3009号)~~
【分类号】：R541.4
【正文快照】： 与西方发达国家不同,根据中国心血管中心的报告,我国心血管疾病呈明显上升趋势[1]。已经有大量的流行病学的资料证实,应该在无症状时给予干预,纠正和改变危险因素。Framingham研究通过随访对相对健康的患者得出实际事件率,并以简单的数个危险因素预测冠心病的长期危险,但是其

【参考文献】