右锁骨下动脉对冠状动脉粥样硬化的预测价值分析  

Clinical value of predicting coronary atherosclerosis by analyzing the lesions of right subclavian artery

作　　者：汪玲[1] 李强[1,2] 仲伟 胡粟[1] 胡春洪[1] 

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215006 [2]浙江省宁波市鄞州人民医院放射科,浙江宁波315175 [3]苏州大学附属第一医院神经内科,江苏苏州215006

出　　处：《医学影像学杂志》2017年第11期2082-2085,共4页Journal of Medical Imaging

摘　　要：目的评估右锁骨下动脉病变对冠状动脉粥样硬化(coronary atherosclerosis,CA)的临床预测价值。方法回顾性分析89例行冠状动脉CT血管造影(coronary artery CT angiography,CCTA)患者的临床资料及右锁骨下动脉、颈动脉超声检查资料。以Gensini积分法计算冠状动脉病变程度,以超声下右锁骨下动脉起始段及颈动脉分叉处内-中膜厚度(intima-media thickness,IMT)评估颈部血管病变。分析右锁骨下动脉起始段及双侧颈动脉分叉处IMT与冠状动脉Genisini积分的相关性,计算两者ROC曲线下面积,评估右锁骨下动脉病变预测CA的临床价值。结果 1)右锁骨下动脉起始段,颈动脉分叉处IMT积分与冠状动脉Gensini积分呈正性相关,且前者高于后者(分别为r=0.627,P<0.01;r=0.439,P<0.01);2)右锁骨下动脉起始段IMT预测CA的效能高于颈总动脉分叉处(灵敏度和特异度分别为79.2%、63.5%;77.3%、61.4%)。结论右锁骨下动脉的IMT程度对CA有重要预测价值。Objective To estimate the clinical value of right subclavian artery in predicting coronary atherosclerosis CA）. Methods Totally, 89 patients＇ informations were retrospectively analyzed, who were examined coronary artery CT angiography （CCTA） , as well as neck vessels ultrasound within a short time. According to the result of CCTA, Gensini scores were calculated to estimate the degree of coronary artery lesions. We recorded the IMT of initial right subclavian artery and carotid artery bifurca- tion in the ultrasonic testing to assess the degree of their lesions and explored the clinical value of right subclavian artery and carot- id artery in predicting coronary atherosclerosis by comparing the correlations of the IMT of both with coronary Gensini score and the areas under the ROC curve. Results 1 ） The IMT of initial right subclavian artery and carotid artery bifurcation were positively correlated with Gensini score, the correlation of the former （ r = 0. 627, P 〈 0.01 ） was higher than that of the latter （ r = 0. 439, P 〈 0. 01 ） ; 2） The efficiency of initial right subclavian artery IMT in predicting coronary atherosclerosis was higher than that of carotid artery bifurcation IMT, with sensitivity of 79.2% , 77.3% and specificity of 63.5%, 61.4%. Conclusion The pathologic degree of right subclavian artery IMT had an important reference value in predicting coronary atberosclerosis.

关 键 词：右锁骨下动脉 内中膜厚度 冠脉粥样硬化 体层摄影术 X线计算机 

分 类 号：R543.3[医药卫生—心血管疾病] R814.42[医药卫生—内科学]