强直性脊柱炎患者冠状动脉计算机断层摄影术表现及其临床特征分析  

Clinical and Angiographic Characteristics Derived From Coronary Artery Computed Tomography in Patients With Ankylosing Spondylitis

作　　者：叶绍东[1] 徐亮[2] 赵杰[1] 张海涛[1] 孙筱璐[1] 李琳[1] YE Shao-dong;XU Liang;ZHAO Jie;ZHANG Hai-tao;SUN Xiao-lu;LI Lin(Department of Cardiology, National Center for Cardiovascular Diseases and Fuwai Hospital, CAMS and PUMC, Beijing（100037）, China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心内科,北京市100037 [2]中国医学科学院北京协和医学院放射科,北京市100037

出　　处：《中国循环杂志》2018年第6期572-575,共4页Chinese Circulation Journal

摘　　要：目的:应用冠状动脉计算机断层摄影术(CT)分析强直性脊柱炎患者的冠状动脉病变特征及其临床特征。方法:回顾性分析2014-01至2017-06期间因胸部不适在中国医学科学院阜外医院接受冠状动脉CT检查的强直性脊柱炎患者33例作为强直性脊柱炎组,另外选择同期年龄、性别匹配的无强直性脊柱炎的患者33例作为对照组,比较两组患者的传统心血管病危险因素、炎症指标以及经CT检测的冠状动脉病变的特点。结果:传统的心血管风险因素的比较:强直性脊柱炎组和对照组患者的体重指数及高血压、吸烟、糖尿病、高脂血症的患者比例差异无统计学意义(P>0.05)。两组患者的血脂水平、血肌酐、尿酸等指标差异也无统计学意义(P>0.05)。强直性脊柱炎组患者的炎症指标血沉[(14.15±12.81)m/s vs(7.79±6.26),P=0.013]、高敏C反应蛋白明显高于对照组[(6.88±5.65)ng/L vs(3.16±3.13)ng/L,P=0.002]。强直性脊柱炎组中合并50%以上狭窄冠状动脉病变的患者[23(69.7%)vs 14(42.4%),P=0.026]、冠状动脉钙化的患者[22(66.7%)vs 9(27.3%),P=0.001]均多于对照组;另外,强直性脊柱炎组患者的钙化积分高于对照组[(133.26±195.97)分vs(21.27±45.33)分,P=0.001]。结论:强直性脊柱炎患者冠状动脉病变狭窄程度高,冠状动脉脉钙化程度明显增加。Objectives： To observe the clinical and coronary artery computed tomography（CT） characteristics of patients with ankylosing spondylitis.Methods： Data from 33 consecutive patients with ankylosing spondylitis admitted due to chest discomfort in Fuwai Hospital from January 2014 to June 2017 were analyzed, 33 age and sex matched patients with no ankylosing spondylitis were selected as the control group. Coronary artery CT features was compared between the two groups.Results： Incidence of hypertension, smoking, diabetes and hyperlipidemia, BMI values were similar between the two groups. Blood lipid level（high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglyceride and, total cholesterol）, creatinine and uric acid values were also similar between the two groups. Erythrocyte sedimentation rate（ESR）（[14.15±12.81]m/s vs [7.79±6.26]m/s, P=0.013） and high C-reactive protein（hs-CRP）（[6.88±5.65]ng/L vs [3.16±3.13]ng/L, P=0.002） values were significantly higher in ankylosing spondylitis group than in the control group. Percent of coronary artery stenosis（50%） was significantly higher in ankylosing spondylitis group than in the control group（23[69.7%] vs 14[42.4%], P=0.026）. Coronary artery calcification was significantly higher in ankylosing spondylitis group than in the control group（22 [66.7%] vs 9[27.3%], P=0.001）.Conclusions： Degree of coronary artery stenosis and calcification as well as inflammatory index（ESR and hs-CRP） are significantly higher in ankylosing spondylitis patients compared to control patients.

关 键 词：脊柱炎 冠状动脉疾病 计算机断层摄影术 

分 类 号：R54[医药卫生—心血管疾病]