138例39~81岁体检人员血管钙化指标的关联分析  

Correlation of vascular calcification indicators in 138 patients aged between 39 and 81 years

作　　者：李娜[1] 张志勉[1] LI Na;ZHANG Zhimian(Department of Health Management Center,Qilu Hospital of Shandong University,Jinan 250012,Shandong,China)

机构地区：[1]山东大学齐鲁医院健康管理中心,山东济南250012

出　　处：《山东大学学报（医学版）》2020年第2期85-89,共5页Journal of Shandong University:Health Sciences

基　　金：山东省重大科技创新工程项目(2019JZZY011110)。

摘　　要：目的探讨骨密度(BMD)和骨代谢相关指标与冠状动脉钙化(CAC)的关系,为CAC高危人群的筛查提供实验依据.方法选取2018年6月到2019年5月在山东大学齐鲁医院健康管理中心做过冠状动脉CT血管造影(CTA)的中老年体检人群(39~81岁)138名作为研究对象.回顾性分析BMD测量结果并将其分为骨质疏松组、骨质减少组与骨量正常组,根据Agatston积分法(AS)计算冠状动脉钙化积分,将各冠状动脉分支所得积分相加得出总积分,根据总积分分为冠状动脉钙化组和无钙化组(钙化组:>10;无钙化组:≤10).并记录各个患者骨代谢相关标志物:总Ⅰ型胶原氨基端延长肽(tP1NP)、β-Ⅰ型胶原羧基端肽(β-CTx)、胎球蛋白A(Fetuin-A)和甲状旁腺素(PTH),及常规生化指标以及基本情况等.结果冠状动脉钙化组与无钙化组的一般资料比较在性别(P<0.001)、年龄(P<0.001)、压差(P=0.01)、空腹血糖(P<0.001)和女性有无绝经(P=0.04)方面差异有统计学意义,既往史中饮酒(P<0.001)和吸烟史(P<0.001)差异有统计学意义,在腰椎骨密度(P=0.01)方面差异有统计学意义,两组在骨代谢相关指标比较发现tP1NP、β-CTx、PTH、Fetuin-A和ALP与冠脉钙化之间差异无统计学意义(P>0.05).冠状动脉钙化积分与性别、年龄、压差、空腹血糖、腰椎骨密度、女性有无绝经、饮酒史及吸烟史有相关性.年龄、空腹血糖和腰椎骨密度这3个变量对冠状动脉钙化积分有一定的影响.结论在中老年人群中,腰椎BMD与CAC有相关性,可作为预测指标.Objective To explore the relationship between bone mineral density(BMD),bonemetabolismrelated indicators and coronary artery calcification(CAC)in order to provide reference for the screening of high-risk CAC population.Methods This study involved 138 subjects(39-81 years)who underwent coronary artery CT angiography(CTA)during June 2018 and May 2019.According to the BMD results,the subjects were divided into osteoporosis group,osteopenia group and healthy group.The coronary artery calcium scoring(CACS)was calculated with Agatston score(AS),and the total CACS was obtained by summing up the scores of the branches.Based on the total CACS,the subjects were divided into CAC group(>10)and non-CAC group(≤10).The bone metabolism related indicators were recorded,including totalⅠtype collagen amino peptide(tP1NP),extendedβ-Ⅰtype collagen peptide(β-CTx),fetal globulin A(Fetuin-A),parathyroid hormone(PTH),and other biochemical indicators.Results There were statistically significant differences in gender(P<0.001),age(P<0.001),pressure difference(P=0.01),fasting blood glucose(P<0.001),menopause(P=0.04),drinking history(P<0.001),smoking history(P<0.001),and lumbar spine density(P=0.01)between the CAC group and non-CAC group.There were no significant differences in tP1NP,β-CTx,PTH,Fetuin-A and ALP between the two groups(P>0.05).CACS was correlated with gender,age,differential pressure,fasting blood glucose,lumbar spinedensity,menopause,history of drinking and smoking.Age,fasting blood glucose and lumbar spine density had a certain effect on CAC score.Conclusion In middle-aged and elderly people,lumbar spine densityis correlated with CAC and can be used as a predictor.

关 键 词：血管钙化 骨质疏松 骨密度 总Ⅰ型胶原氨基端延长肽 β-Ⅰ型胶原羧基端肽 

分 类 号：R541.4[医药卫生—心血管疾病]