CTA参数及Hcy与冠状动脉病变程度的相关性及其对预后的预测价值  

Correlation of CTA Parameters and Hcy with the Degree of Coronary Artery Disease and Their Prognostic Value

作　　者：李培恒 陈杰[1] 胡莹[1] 刘小焕[1] 梁长华[1] LI Peiheng;CHEN Jie;HU Ying;LIU Xiaohuan;LIANG Changhua(Radiology Department,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院放射科,河南新乡453100

出　　处：《河南医学研究》2024年第8期1437-1440,共4页Henan Medical Research

摘　　要：目的探讨CT血管造影(CTA)参数及同型半胱氨酸(Hcy)与冠状动脉(简称冠脉)病变程度的相关性及其对预后的预测价值。方法回顾性选取2019年6月至2020年9月新乡医学院第一附属医院收治的98例冠心病(CHD)患者,纳入研究组,根据1∶1选例原则,另选取同期、同年龄段健康体检者98例,纳入对照组。比较两组、不同冠脉病变程度及不同预后患者CTA参数[最小管腔直径(MLD)、最小管腔面积(MLA)、斑块总体积(TPV)]及血清Hcy水平,分析CTA参数及血清Hcy水平与冠脉病变程度之间的相关性,并分析联合应用对预后情况的预测价值。结果观察组CTA参数MLD、MLA值小于对照组,TPV值及血清Hcy水平高于对照组(P<0.05)。不同冠脉病变程度患者MLD、MLA值比较:重度病变<中度病变<轻度病变。TPV值及血清Hcy水平比较:重度病变>中度病变>轻度病变(P<0.05)。MLD、MLA值与冠脉病变程度呈负相关,TPV值及血清Hcy水平与之呈正相关(P<0.05)。预后不良患者MLD、MLA值小于预后良好患者,TPV值及血清Hcy水平高于预后良好患者,且联合预测CHD患者预后不良的曲线下面积为0.899,最佳诊断敏感度为90.16%,最佳诊断特异度为89.19%,约登指数0.794。结论CTA参数MLD、MLA、TPV值及血清Hcy水平与CHD患者冠脉病变程度具有一定相关性,联合应用对预后不良具有一定预测价值,可作为临床评估病变程度及预后的有效方案之一。Objective To investigate the correlation between CT angiography(CTA)parameters,homocysteine(Hcy)and the degree of coronary artery lesions and its prognostic value.Methods Ninety-eight patients with coronary heart disease(CHD)admitted to the First Affiliated Hospital of Xinxiang Medical College from June 2019 to September 2020 were retrospectively selected into the study group,and 98 healthy physical examination patients of the same period and age were selected to be included in the control group according to the 1∶1 case selection principle.CTA parameters[minimum lumen diameter(MLD),minimum lumen area(MLA),total plaque volume(TPV)]and serum Hcy levels were compared between the two groups,patients with different degrees of coronary artery disease and different prognosis,and the correlation between CTA parameters and serum Hcy level and the degree of coronary artery disease was analyzed,and the predictive value of combined application on prognosis was analyzed.Results CTA parameters MLD and MLA values in observation group were lower than those in control group,TPV values and serum Hcy levels were higher than those in control group(P<0.05).Comparison of MLD and MLA values in patients with different degrees of coronary artery disease:severe disease<moderate disease<mild disease.Comparison of TPV value and serum Hcy level:severe disease>moderate disease>mild disease(P<0.05).MLD and MLA were negatively correlated with the degree of coronary lesions,while TPV and serum Hcy were positively correlated(P<0.05).The MLD and MLA values of patients with poor prognosis were lower than those of patients with good prognosis,the TPV values and serum Hcy levels were higher than those of patients with good prognosis,and the area under the curve of patients with combined prediction of poor prognosis was 0.899,the best diagnostic sensitivity was 90.16%,the best diagnostic specificity was 89.19%,and the Yeoden index was 0.794.Conclusion CTA parameters MLD,MLA,TPV and serum Hcy level have a certain correlation with the degree of coron

关 键 词：CT血管造影 同型半胱氨酸 冠心病 冠脉病变 预后 

分 类 号：R445.3[医药卫生—影像医学与核医学]