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冠心病患者升主动脉弹性与CT影像学特征的相关性分析*

作者:龚中明1 江志荣2 徐峻峰2

所属单位:1.湖北省鄂州市莲花山医院心内科(湖北 鄂州 436000) 2.湖北省鄂州市中心医院内科(湖北 鄂州 436000)

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摘要

目的探讨冠心病患者升动脉 弹性与冠状动脉狭窄程度的相关性。方 法 选择2013年5月-2014年5月入住我院 拟诊为冠心病患者126例为研究对象, 所有患者均行DSCT冠脉造影检查,根据 有无冠脉狭窄分为冠脉狭窄组、无冠脉 狭窄组,根据冠脉狭窄程度分为轻度狭 窄组、中度狭窄组、重度狭窄组;比较 不同组间主动脉弹性参数和Gensini评 分。结果 1冠脉狭窄组相对直径变化率 (%Ao)、膨胀性(AoD)、顺应性(AoC)明显 低于非狭窄组,僵硬度(AoSI)、Gensini 评分明显高于非狭窄组(t=6.849-34.201, P<0.05, P<0.01);2轻度组%Ao、AoD、 AoC明显高于中度组、重度组,AoSI、 Gensini评分明显低于中度组、重度组, 中度组%Ao、AoD、AoC明显高于重度组, AoSI、Gensini明显低于重度组(t=3.456- 17.542,P<0.05、0.01)。3Gensini评分与 AoSI呈显著正相关(r=0.722,P<0.001), 与%Ao、AoD呈显著负相关(r=-0.432、 0.261,P<0.001)。结论 升主动弹性指标 与冠状动脉狭窄程度有良好的相关性,定 期检测升主动脉血管弹性功能有助于亚临 床状态患者的早期干预与治疗

Objective To study correlation of ascending aorta elastic and CT imaging features in patients with coronary heart disease. Methods 126 cases patients with CHD were selected as the research object, all patients were given DSCT coronary angiography examination, according to the presence of coronary artery stenosis were divided into coronary stenosis group and no coronary stenosis group, according to the extent of coronary stenosis were divided into mild stenosis, moderate stenosis group, severe stenosis group; ascending aorta elastic parameters and the Gensini score were compared between different groups. Results 1 Coronary stenosis group % Ao, AoD, AoC were was significantly than that no stenosis group, AoSI, the Gensini score were significantly higher than no stenosis group (t=6.849-34.201, P<0.05, P<0.01); 2 Mild group % Ao, AoD, AoC were significantly higher than that of moderate group, severe group, AoSI, Gensini score were significantly lower than the moderate group and severe group, moderate group % Ao, AoD, AoC were significantly higher than that of severe group, AoSI, Gensini were significantly lower than the severe group (t=3.456-17.542, P<0.05,P<0.01); 3 Gensini score and AoSI significant positive correlation(r=0.722, P<0.001), and % Ao, AoD significant negative correlation (r=-0.432, 0.261, P<0.001). Conclusion Ascending aorta elastic and coronary artery stenosis degree have good correlation, regular detection ascending aorta elastic function help to early intervention and treatment in patients with subclinical state

【关键词】冠心病;体层摄影术;升主动脉弹性;冠状动脉狭窄

【中图分类号】R445.3;R541.4

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2015.10.016

前言

冠心病是指因冠状动脉粥样硬化和/或冠状动脉痉挛导致心肌缺 血缺氧或坏死而引起的心脏病,冠状动脉狭窄是其主要病理机制之 一。主动脉弹性(aortic elasticity)是指作用于单位压力下血管腔 直径、横截面积的变化程度,反映出动脉舒缩功能,是评价动脉管壁 功能的重要参数,也是评价亚临床血管病变的敏感指标[1]。研究表明 升主动脉弹性功能与冠脉狭窄程度、不良心血管事件密切相关。双源 CT(dual-sourc computed tomography,DSCT)因其高空间、高时间分辨 率,可以准确测量主动脉弹性指标以及冠脉狭窄程度,但应用于冠状 动脉病变与主动脉弹性相关性研究的文献报道较少[2]。本研究旨在通 过双源CT测量与评价升主动脉弹性指标,结合冠状动脉Gesini积分评 价系统,定量分析主动脉弹性与冠脉狭窄的关系。