CT冠状动脉造影高估冠状动脉狭窄程度的影响因素分析  

Factors of overestimation of coronary artery stenosis by CT coronary angiography

作　　者：张斌[1] 刘继轩 王锦达[2] 张华巍[2] 蒋博[2] 张凯[1] 赵海英 宋林楠 陈光辉[2] 孙志军[2] ZHANG Bin;LIU Jixuan;WANG Jinda;ZHANG Huawei;JIANG Bo;ZHANG Kai;ZHAO Haiying;SONG Linnan;CHEN Guanghui;SUN Zhijun(Puyang People’s Hospital,Puyang 457000,Henan Province,China;The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China;Queen Mary College of Nanchang University,Nanchang 330031,Jiangxi Province,China)

机构地区：[1]濮阳市人民医院,河南濮阳457000 [2]解放军总医院第一医学中心,北京100853 [3]南昌大学玛丽女王学院,江西南昌330031

出　　处：《解放军医学院学报》2019年第3期215-218,共4页Academic Journal of Chinese PLA Medical School

基　　金：国家重点研发计划精准医学研究专项(2017YFC0908700)~~

摘　　要：目的识别CT冠状动脉造影高估冠状动脉狭窄程度的影响因素。方法选取2017年1月-2018年1月于濮阳市人民医院放射科接受CT冠状动脉造影检查,且至少1支冠状动脉狭窄程度≥75%并接受有创的选择性冠状动脉造影的患者为研究对象,以有创的选择性冠状动脉造影为诊断标准判断CT冠状动脉造影是否高估冠状动脉狭窄程度,使用logistic回归分析CT冠状动脉造影高估狭窄程度的危险因素。结果共819例患者入组,其中男性564例,女性255例,平均年龄(65.9±10.9)岁,logistic分析显示年龄大(OR=1.12,P=0.000)、心率快(OR=1.181,P=0.001)、房颤(OR=4.37,P=0.000)及冠脉钙化(OR=2.90,P=0.002)与CT冠状动脉造影高估冠状动脉狭窄程度显著相关。结论高龄、心率快、房颤及冠状动脉钙化患者更容易出现CT冠状动脉造影高估冠状动脉狭窄程度的情况。Objective To identify the inuencing factors of CT coronary angiography overestimating the severity of coronary artery stenosis.Methods Patients undergoing CT coronary angiography in the department of radiology,Puyang People’s Hospital from January 2017 to January 2018 were enrolled in this study.Invasive selective coronary angiography was performed as the diagnostic criterion to determine whether CT coronary angiography overestimating the degree of coronary artery stenosis.Logistic regression analysis was used to identify factors of overestimation based on baseline clinical data and results of CT coronary angiography.Results Totally 819 cases(564 males and 255 females with average age of 65.9±10.9 years)were included in this study.Logistic regression showed that age(adjusted OR,1.12 per 1 year,P=0.000),heart rate(adjusted OR,1.18 per 1 beat/min,P=0.001),atrialbrillation(adjusted OR,4.37,P=0.000),and calcication(adjusted OR,2.90,P=0.002)were independently associated with CT coronary angiography overestimating the degree of coronary artery stenosis.Conclusion Aging,accelerated heart rate,atrialbrillation,calcication are independent factors of overestimation of coronary artery stenosis by CT coronary angiography.

关 键 词：冠状动脉CT造影 冠状动脉狭窄 误诊学 诊断 

分 类 号：R541.4[医药卫生—心血管疾病]