冠状动脉钙化积分对疑似心源性慢性胸痛患者心血管事件的预测意义  

Prognostic value of coronary artery calcification in patients with suspected cardiogenic chronic chest pain

作　　者：王泽静[1] 王询 肖康[1] WANG Ze-jing;WANG Xun;XIAO Kang(Department of CT Room,the First Hospital of Qinhuangdao,Hebei Province,Qinhuangdao 066000,China;Department of Coronary Care Unit,the First Hospital of Qinhuangdao,Hebei Province,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院CT室,河北秦皇岛066000 [2]河北省秦皇岛市第一医院CCU,河北秦皇岛066000

出　　处：《河北医科大学学报》2019年第4期456-460,共5页Journal of Hebei Medical University

摘　　要：目的应用多排螺旋CT研究疑似心源性慢性胸痛患者冠状动脉钙化(coronary artery calcification,CAC)积分对心血管事件的影响。方法序贯入选就诊的疑似心源性慢性胸痛患者101例,行64排螺旋CT扫描(非增强),计算CAC积分,依据CAC积分将患者分为CAC积分≤300分和CAC积分>300分2组。观察随访1年,观察终点事件为急性心肌梗死、心源性死亡、因急性冠状动脉综合征再入院和血运重建。结果 101例患者发生心血管事件13例,均为因急性冠状动脉综合征再入院,无心源性死亡和急性心肌梗死发生,其中CAC积分≤300分组发生4例,CAC积分>300分组发生9例。CAC积分>300分组糖尿病患病比例、总胆固醇水平均高于CAC积分≤300组,差异有统计学意义(P<0.05)。应用Cox比例风险回归模型进行分析,结果显示CAC积分>300分的HR值为4.616,95%CI为1.046～20.377,P=0.043。结论 CAC积分>300分是疑似心源性慢性胸痛患者发生心血管事件的危险因素。Objective To evaluate the prognostic value of the coronary artery calcium(CAC)score in patients with suspected cardiogenic chronic chest pain.Methods A total of 101 consecutive patients with suspected cardiogenic chronic chest pain were enrolled from our hospital.The CAC score was calculated and patients were divided into a lower CAC score group(CAC score≤300)and a higher CAC score group(CAC score>300).Patients were followed up for one years to assess adverse events consisting of a combined end point of cardiac death,myocardial infarction,coronary revascularisation,and returning to hospital for acute coronary syndrome(ACS).Results During the observation period no patients died or suffered from myocardial infarction and 13 patients returned to the hospital for ACS.Among them,4 cases occurred in the group with CAC score ≤300,and 9 cases occurred in the group with CAC score>300.The proportion of diabete and total cholesterol level of group with CAC score >300 were higher than that of the group with CAC score≤300,and the difference was statistically significant(P<0.05).The Cox regression analysis results showed that the CAC score was a risk factor for the no-event survival time(HR=4.616;95% CI=1.046-20.377,P=0.043).Conclusion CAC score>300 is a predictor of cardiac events for patients with suspected cardiogenic chronic chest pain.

关 键 词：胸痛 冠状动脉钙化积分 心血管事件 

分 类 号：R441.1[医药卫生—诊断学] R541.4[医药卫生—临床医学]