第3代双源CT对青年疑诊冠心病患者冠状动脉病变的回顾性分析  

Retrospective analysis of coronary artery in young patients with suspected coronary heart disease by third generation dual source CT

作　　者：于方方 李文欢 李娜 侯东燕 张卫国[1] 蒋涛[1] YU Fangfang;LI Wenhuan;LI Na;HOU Dongyan;ZHANG Weiguo;JIANG Tao(Department of Radiology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing,100020,China;Department of Cardiology,Heart Center,Beijing Chao-Yang Hospital,Capital Medical University)

机构地区：[1]首都医科大学附属北京朝阳医院放射科,北京100020 [2]首都医科大学附属北京朝阳医院心脏中心

出　　处：《临床心血管病杂志》2021年第2期118-121,共4页Journal of Clinical Cardiology

基　　金：重大慢性非传染性疾病防控研究重点专项(No:2016YFC1300400)。

摘　　要：目的:探讨冠状动脉CT造影成像对疑诊冠心病青年门诊患者的筛查情况并分析冠状动脉(冠脉)病变的危险因素。方法:选取2019年1月—2019年12月就诊于我院门诊行冠脉CT的疑诊冠脉病变的青年患者(≤45岁),根据冠脉CT评价其冠脉情况,记录临床资料,分析其临床危险因素与冠脉病变的关系。结果:(1)冠脉钙化积分(CACS)为0分者其冠脉狭窄概率为16.1%,提示冠心病(狭窄≥50%)的概率为2.3%,随着CACS增多,提示冠心病的概率逐渐增高。CACS≥100分者冠脉狭窄概率为100%,其中66.7%提示存在冠心病。(2)冠脉不同狭窄组年龄、性别、高血压、高脂血症、糖尿病、高尿酸、吸烟、饮酒的差异均有统计学意义(P<0.05)。二元Logistic回归分析显示,青年冠心病的最强独立预测因素为高血脂与吸烟。(3)冠脉畸形发生率为1.6%,冠脉肌桥发生率为21.9%。结论:在青年疑诊冠心病门诊患者中,冠脉CT造影对排除及诊断冠脉病变有重要的应用价值。Objective: To investigate the application value of coronary CT angiography(CCTA) in screening and analyzing coronary heart disease in young outpatients with suspected coronary heart disease. Methods: Young outpatients(≤ 45 years old) with suspected coronary artery disease undergoing coronary CTA in our hospital from January 2019 to December 2019 were selected. Their coronary artery conditions were evaluated according to coronary CT, the clinical conditions were recorded, and the relationship between clinical risk factors and coronary artery disease was analyzed. Results:(1) The probability of coronary artery stenosis was 16.1% when coronary artery calcium score(CACS) was 0, and the probability of coronary heart disease(stenosis ≥ 50%) was 2.3%. With the increase of CACS, the probability of coronary heart disease was gradually increased. The incidence of coronary artery stenosis in patients with CACS ≥ 100 was 100%, of which 66.7% indicated coronary heart disease.(2) There were significant differences in age, gender, hypertension, hyperlipidemia, diabetes, hyperuricemia, smoking and drinking between different coronary stenosis groups(P<0.05). Binary logistic regression analysis showed that hyperlipidemia and smoking were the strongest independent predictors of coronary heart disease in young people.(3) The incidence of coronary artery malformation was 1.6%, and the incidence of coronary artery muscle bridge was 21.9%. Conclusion: In young patients with suspected coronary heart disease, coronary artery CT angiography has an important application value in excluding and diagnosing coronary artery disease.

关 键 词：青年 冠状血管CT造影 冠状动脉硬化 

分 类 号：R543[医药卫生—心血管疾病]