左主干走行及分叉角度对左冠状动脉粥样硬化的影响  

Effect of course and bifurcate angle of left main coronary artery on left coronary atherosclerosis

作　　者：宋翔[1] 田树平[2] 具海月[1] 甘露[1] 杨立[1] 

机构地区：[1]解放军总医院放射科,北京100853 [2]海军总医院放射科,北京100048

出　　处：《解放军医学院学报》2015年第1期62-65,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨冠状动脉左主干走行状态及分叉角度对左冠状动脉粥样硬化斑块形成和分布的影响。方法回顾性分析解放军总医院2013年10-12月110例行CT冠状动脉血管成像检查者,根据左主干走行状态将受检者分为折曲组42例和非折曲组68例,测量左主干分叉角度及斑块距分叉处的距离,研究左主干走行状态及分叉角度与左冠状动脉粥样硬化斑块发生情况的相关性。结果折曲组左冠状动脉粥样硬化斑块的发生率高于非折曲组(P<0.01),其中左主干和前降支斑块的发生率折曲组均高于非折曲组(P<0.05),回旋支斑块的发生率两组差异无统计学意义(P>0.05)。64例前降支存在斑块,左主干分叉角度与斑块距分叉处的距离之间存在负相关(r=-0.314,P<0.05),18例回旋支存在斑块,左主干分叉角度与斑块距分叉处的距离之间无相关性(r=-0.309,P>0.05)。结论左主干走行折曲及大的分叉角更易使左冠状动脉形成斑块,可作为冠状动脉粥样硬化的危险因素,且左主干分叉角度越大,前降支斑块越接近分叉处。bjective To explore the effect of the course and bifurcate angle of left main coronary artery on atherosclerotic plaques formation and distribution. Methods Clinical data about 110 people receiving CT coronary angiography from October 2013 to December 2013 were retrospectively analyzed. All subjects were divided into two groups according to the course of the left main coronary artery（LM）： tortuous LM traveling group（42 cases） and no tortuous LM traveling group（68 cases）. The bifurcate angle of the LM was measured. The correlation between the course and bifurcate angle of the LM and the occurrence of atherosclerosis were observed. Results Compared with no tortuous group, the incidence of the left coronary artery atherosclerosis was significantly higher in tortuous group（P 0.01）, and the incidence of plaques located in the LM or LAD was also higher in tortuous group（P 0.05）,while the incidence of plaques located in the LCX showed no statistically significant difference between two groups（P 0.05）. There existed negative correlation between the bifurcate angle of the LM and the plaque from the distance of the bifurcation in 64 patients with LAD lesions（r=-0.314, P 0.05）, while there was no correlation between the bifurcate angle of the LM and the plaque from the distance of the bifurcation in 18 patients with LCX lesions（r=-0.309, P 0.05）. Conclusion Plaque is more easily formed in the left coronary artery with tortuosity or big bifurcation angle which can be a risk factor for atherosclerosis. The bifurcate angle of the LM also plays an important role in the distribution of plaques.

关 键 词：冠状动脉疾病 左主干 分叉角 计算机体层摄影术 

分 类 号：R543.3[医药卫生—心血管疾病]