多排CT评价冠状动脉斑块变化与血脂的关系  

Relation between coronary atherosclerotic plaques and lipid evaluated by multidetector computed tomography

作　　者：王志国[1] 盖鲁粤[1] 蒋博[1] 任学文[1] 汪奇[1] 杨霞[1] 李萍[1] 陈韵岱[1] 杨立[1] 关志伟[1] 

机构地区：[1]解放军总医院心血管内科,北京100853

出　　处：《军医进修学院学报》2010年第5期449-451,共3页Academic Journal of Pla Postgraduate Medical School

基　　金："十一.五"国家科技支撑计划(2006BAI01A02)~~

摘　　要：目的以无创多排螺旋CT观察冠状动脉斑块的变化及其与血脂的关系。方法冠脉CT患者46例,平均年龄（56.1±1.7）岁,平均随访时间（251.8±13.1）d,同时检查空腹血脂（总胆固醇,甘油三酯,高密度脂蛋白胆固醇,低密度脂蛋白胆固醇）。取前后两次CT检查同一部位血管断面图测非钙化斑块面积,血管狭窄程度和CT值,CTHU值（-10）~158定义为斑块,〉159为管腔。按血管狭窄程度加重和减轻分为恶化组和改善/稳定组,比较两组血脂控制情况,并进行相关分析。结果总体血脂控制情况一般,TC和LDL-C有轻度增加,狭窄程度也有增加趋势,斑块CT值下降。稳定组TC控制情况明显好于恶化组（3.86±0.83vs4.53±1.32,P=0.0240）,LDL-C控制情况也明显好于恶化组（2.11±0.56vs2.57±0.99,P=0.0301）。回归分析表明狭窄减轻和LDL-C呈显著负相关（r=0.3099,P=0.0361）,病变无进展的LDL-C界值为1.94mmol/L。结论控脂可以减缓冠脉斑块进展,冠脉斑块和血管狭窄的变化可用无创多排CT监测。Objective To observe the relation between coronary plaques and lipid by noninvasive multidetector computed tomography（MDCT）.Methods A total of 46 patients including 6 females and 40 males at the age of 56.1±1.7 years underwent dual-source CT and were followed up for 251.8±13.1 days.Their fasting lipid levels including TC,TG,HDL-C and LDL-C were measured.The HU range for plaques and lumen was defined as-10-158 and 159,respectively,with calcified plaques excluded.Coronary stricture,area and CT value of coronary plaques were calculated using these cut-offs.Patients were divided into two groups according to their aggravated or improved coronary stricture.Results The TC and LDL-C were slightly increased,coronary stricture tended to aggravate,and CT value of coronary plaques was decreased.The TC and LDL-C were significantly lower in patients with stable conditions than in those with aggravated conditions（3.86±0.83 vs 4.53±1.32,P=0.024 0;2.11±0.56 vs 2.57±0.99,P=0.030 1）.Regression analysis showed that improvement in coronary stricture was negatively correlated with LDL-C（r=0.309 9,P=0.036 1）.The LDL-C was 1.94mmol/L in those with no progression of their coronary stricture.Conclusion Lipid control can alleviate the progression of coronary plaques and non-invasive MDCT can be used to monitor changes in coronary plaques and stricture.

关 键 词：血脂异常 冠状动脉疾病 MDCT(多排CT) 

分 类 号：R445.3[医药卫生—影像医学与核医学]