经胸彩超心脏部分组织钙化评估对冠心病的预测价值  

The Predictive Value of Cardiac Calcification Assessment by Transthoracic Echocardiography for Evaluating the Severity of Coronary Heart Disease

作　　者：王蕊 李诺 刘爱玲 蒋春英[2] WANG Rui;LI Nuo;LIU Ailing;JIANG Chunying(Department of Ultrasound,the Third Affiliated Hospital of Xuzhou Medical University,Jiangsu Xuzhou 221003,China;Department of Cardiology,Xuzhou Central Hospital,Jiangsu Xuzhou 221009,China)

机构地区：[1]徐州医科大学附属第三医院彩超室,江苏徐州221003 [2]徐州市中心医院心内科,江苏徐州221009

出　　处：《中国医药导刊》2018年第11期664-668,共5页Chinese Journal of Medicinal Guide

基　　金：徐州市科技局应用基础研究计划(项目编号:KC17101;项目名称:flt3基因转染对大鼠心肌缺血再灌注损伤保护作用及机制的实验研究)

摘　　要：目的:探讨患者心脏钙化病变与冠心病之间的关系。方法:共收集2016年1～12月期间775名住院疑似冠心病患者。运用经胸超声心动图评估二尖瓣环、主动脉根部及主动脉瓣钙化程度,同时进行冠状动脉造影术评估冠状动脉病变情况。结果:与无钙化组相比,钙化组患者年龄显著增长(P <0. 05),高血压病人群比例增加(P <0. 05);多部位钙化组高胆固醇血症及糖尿病人群比例增加(P <0. 05);三部位钙化分组的男性比例降低,左心室舒张末期内径(LVEDD)增大,左心室射血分数(LVEF)降低(P <0. 05)。随着心脏钙化程度的增加,冠状动脉造影阳性的发生率逐渐增加(P <0. 05);且无钙化组以单支病变多见(P <0. 05),而多钙化组以左主干及多支病变多见(P <0. 05)。多因素Logistic回归分析提示:心脏多部位钙化可能成为新的独立的预测因子,预测价值高(P=0. 004)。结论:经胸彩超心脏部分组织钙化评估法是评估患者冠状动脉病变的有效手段,具有重大的冠心病预测价值。Objective:To investigate the relationship between cardiac calcification and coronary heart disease(CHD).Methods:From January to December 2016,a total of 775 hospitalized suspected patients with CHD participated in this study.Transthoracic echocardiography was used to assess the severity of calcification in mitral annulus,aortic root and aortic valve.Coronary angiography was performed to determine the extent of coronary lesion during the same period.Results:Compared with no-calcium deposits group,patients in calcium deposits group were older(P<0.05),and the proportion of patients with hypertension increased(P<0.05).Compared with no-calcium deposits group,the ratio of patients with hypercholesterolemia and diabetes mellitus rised in subgroups of multiple calcium deposits(P<0.05).In subgroup of three calcium deposits,amount of males was less,and the values of left ventricular end-diastolic diameter(LVEDD)increased while left ventricular ejection fraction(LVEF)reduced(P<0.05).Positive rate of coronary angiography increased as cardiac calcification enhanced gradually(P<0.05).Single vessel lesion was frequent in patients of no calcium deposits group(P<0.05)while left main and multiple branches coronary disease were prevalent in subgroup of multiple calcium deposits(P<0.05).By logistic analyses,multiple calcium deposits might be a new independent predictor for the positive prevalence of coronary heart disease(P=0.004).Conclusion:Cardiac calcification assessment by transthoracic echocardiography is an effective means for significantly predicting the severity of CHD.

关 键 词：心脏钙化评估 冠心病 经胸超声心动图 

分 类 号：R541.4[医药卫生—心血管疾病] R445.1[医药卫生—内科学]