冠状动脉异常起源与粥样硬化性斑块的相关研究

发布时间：2018-01-25 05:25

本文关键词： 冠状动脉起源异常斑块　出处：《辽宁医学院》2012年硕士论文　论文类型：学位论文

【摘要】：目的利用320排螺旋CT(血管成像)对冠状动脉起源异常患者进行成像研究，通过CT成像及影像学表现来探讨不同类型冠状动脉异常起源患者其粥样硬化性斑块的发生概率，为临床提供相应的诊断依据，从而预防临床猝死事件的发生。材料与方法回顾性分析2009年12月至2011年5月在济南军区总医院CT室成功行320排冠状动脉成像的6568例患者，其中共检测出94例AOCA患者并对其进行回顾性分析。全部患者均采用ToshibaAquilion one320排容积CT进行冠状动脉成像，统计出不同类型冠状动脉起源的类型比例，并分析较大样本类型AOCA对应的血管粥样硬化性斑块的发病率。同时随机抽取35名正常人群，作为对照组，并统计出正常人群每支冠状动脉粥样硬化性斑块的发生率，随后应用起源异常的相应的血管其粥样硬化性斑块的发生率与正常人群对应血管粥样硬化斑块发生率进行χ2比较。对照组排除标准为患有冠状动脉异常起源患者。结果 320排CT可以对心脏进行快速容积扫描，从而快速得到容积数据，自2009年12月至2011年5月在济南军区总医院CT室成功行320排冠状动脉成像的6568例患者共检出94例AOCA患者。其发生率为1.43%，95例患者年龄为20～85岁，中位年龄为55.46岁，男性72例，女性22例，其中检测出(1) RCA开口高位例数14例，发生率为14.89%。(2) RCA开口于左窦例数为36例，发生率为38.30%。(3) LM开口高位例数为12例，发生率为12.77%。(4) LAD/LCX分别开口于左窦(主干缺如)例数为23例，发生率为24.47%。(5) LCX起源于右冠例数为9例，发生率为9.57%。正常人群对应的(1)LAD35人有14例有斑块，发生率为40%。(2)LCX35例有6例，发生率为17.14%。(3)RAC35例有5例有斑块，发生率为14.29%。后应用异常起源患者其对应的血管与正常人群相应的血管进行χ2比较。得出只有右冠起源于左窦时，右冠状动脉粥样硬化性斑块的发生率为41.47%，与正常人群右冠状动脉粥样硬化性斑块发生率14.29%相比，差异具有统计学意义（P0.05），其余均无统计学意义（P0.05）结论 320排CT能够成功的对心脏进行容积扫描，它能够清楚显示血管及其走行，由以上数据得出大多数冠状动脉异常起源对粥样硬化性斑块没有统计学意义，只有右冠起源于左窦时其（P0.05）具有统计学意义，在此建议应同糖尿病、高血压等一同列为粥样硬化斑块好发因素之一，当检查出AOCA尤其是右冠起源于左窦时应格外注意，，从而指导临床治疗并预防急性冠状动脉综合症的发生。
[Abstract]:Purpose Patients with abnormal origin of coronary artery were studied with 320 slice spiral CT (angiography). To explore the probability of atherosclerotic plaques in patients with different types of abnormal origin of coronary artery by CT imaging and imaging findings, and to provide a basis for clinical diagnosis. In order to prevent the occurrence of clinical sudden death events. Materials and methods A retrospective analysis of 6568 patients who underwent 320 row coronary angiography in CT room of Jinan military region General Hospital from December 2009 to May 2011 was retrospectively analyzed. A total of 94 patients with AOCA were detected and analyzed retrospectively. All patients were performed coronary angiography with ToshibaAquilion one320 slice volume CT. The incidence of atherosclerotic plaques corresponding to large sample type AOCA was analyzed. 35 normal subjects were randomly selected as control group. The incidence of atherosclerotic plaque in each coronary artery in normal population was calculated. Then the incidence of atherosclerotic plaques in the corresponding vessels with abnormal origin was compared with that in the normal population. The exclusion criteria in the control group were the abnormal origin of coronary artery. Results A 320 slice CT scan of the heart can quickly obtain volume data by performing a rapid volumetric scan of the heart. From December 2009 to May 2011, a total of 94 cases of AOCA were detected in 6568 patients who underwent 320 row coronary angiography successfully in the CT room of Jinan military region General Hospital. The incidence rate was 1. 4. 3%. The age of 95 patients was 20 ~ 85 years old with a median age of 55.46 years. There were 72 males and 22 females. Among them 14 cases were detected with high RCA opening. The incidence of RCA opening in the left sinus was 36 cases, and the incidence rate was 38.30%. The incidence of LAD/LCX was 12.77%. The number of cases with LAD/LCX opening to the left sinus (absence of main trunk) was 23 cases. The incidence of LCX originated from the right corona in 9 cases and the incidence rate was 9.57.The incidence of LCX was 9.57.The plaque was found in 14 of the 35 normal subjects. The incidence of LCX35 was 40%, 6 cases were LCX, and the incidence was 17.14%. 5 cases had plaque. The incidence rate was 14.29.The corresponding blood vessels of the patients with abnormal origin were compared with the corresponding blood vessels of the normal population by 蠂 ~ 2. Only the right corona originated from the left sinus. The incidence of atherosclerotic plaque in the right coronary artery was 41.47, which was significantly higher than that in the normal group (14.29%, P 0.05). The rest had no statistical significance (P0.05). Conclusion 320 slice CT can successfully scan the heart volume, it can clearly show the blood vessels and their paths, from the above data we can conclude that most of the abnormal origin of coronary artery has no statistical significance for atherosclerotic plaque. Only the right corona originated from the left sinus (P0.05) has statistical significance. It is suggested that diabetes and hypertension should be one of the risk factors for atherosclerotic plaques. In order to guide clinical treatment and prevent the occurrence of acute coronary syndrome (ACS), we should pay special attention to the detection of AOCA, especially the origin of right coronary artery.
【学位授予单位】：辽宁医学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.2

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