CT冠脉钙化积分与冠心病冠脉狭窄程度的关系及预测MACE的价值  

Relationship between CT Coronary Calcification Score and Coronary Stenosis Degree of Coronary Heart Disease and Its Predictive Value of MACE

作　　者：徐雪颖 巫迎春 赵志维 邵元伟 史斌 XU Xue-YING;WU Ying-Chun;ZHAO Zhi-Wei;SHAO Yuan-Wei;SHI Bin(Department of Imaging,Affiliated Hospital of Jiangsu University,Zhenjiang 212000,Jiangsu Province,China)

机构地区：[1]江苏大学附属医院影像科,江苏镇江212000

出　　处：《中国CT和MRI杂志》2024年第10期62-64,共3页Chinese Journal of CT and MRI

基　　金：江苏省卫生健康委医学科研课题(ZD20210022)。

摘　　要：目的 分析CT冠脉钙化积分与冠心病冠脉狭窄程度的关系及预测心血管不良事件(MACE)的价值。方法选择2020年7月至2021年7月就诊于本院的108例冠心病患者作为研究对象,所有患者均接受冠脉CT血管成像(CTA)检查,计算CT冠脉钙化积分,分析CT冠脉钙化积分(TCS与Shemesh积分)与冠心病冠脉狭窄程度的关系。收集所有患者一般资料(性别、年龄、基础疾病、吸烟史等),根据是否合并MACE分为MACE组与无MACE组,经单因素及多因素Logisti c回归分析M ACE发生的危险因素;绘制ROC曲线,分析CT冠脉钙化积分预测MACE发生的价值。结果根据冠脉造影检查结果将108例冠心病患者分为轻度狭窄组43例(39.81%)、中度狭窄组51例(47.22%)重度狭窄组14例(12.96%);重度狭窄组的TCS评分、Shemesh积分最高,中度狭窄组其次,轻度狭窄组最低(P<0.05);经Kendall的tau-b(K)检验,TCS评分、Shemesh积分与冠脉狭窄程度呈正相关(r=0.751、0.674,P均<0.05);Pearson相关性发现,冠心病患者的TCS评分与Shemesh积分呈正相关(r=0637,P<0.05);MACE组与无MACE组的性别、年龄、BMI、病程、吸烟史、糖尿病、高血压及血脂异常对比,差异无统计学意义(P>0.05);MACE组NT-proBNP、TCS评分及S hem esh积分均高于无MAC E组(P<0.005);经Logistic回归分析,结果显示,NT-proBNR、TCS评分及Shemesh积分是影响冠心病合并MACE发生的危险因素(OR>1,P<0.05);ROC曲线结果发现,TCS评分、Shemesh积分及联合预测冠心病合并MACE发生的AUC为0.796(95%CI:0.694-0.899)、0.770(95%CI:0.648-0.891)、0.816 (95%CI:0.722-0.909)。结论 CT冠脉钙化积分与冠心病冠脉狭窄程度呈正相关,TCS评分、Shemesh积分是影响MACE发生的危险因素,且二者联合可提高预测冠心病合并MACE发生的价值。Objective To analyze the relationship between CT coronary calcification score and the degree of co ronary stenosis in co ronary hea rt disease and the value of predicting ca rdiovascula r adve rse events(MACE).Methods A total of 108 patients with co ronary heart disease admitted to our hospital from July2020 to July 2021 were selected as the study objects.All patients received coronary CT angiography(CTA) examination,computed CT coronary artery calcification scores,and analyzed the relationship between CT coronary artery calcification scores(TCS and Shemesh scores) and coronary artery stenosis degree.General data(gender,age,underlying diseases,smoking history,etc.) of all patients were collected and divided into MACE group and non-MACE group according to whether they were combined with MACE.The risk factors of MACE were analyzed by univariate and multivariate Logistic regression.ROC cu rve was drawn to analyze the value of CT corona ry calcification score in predicting the occurrence of MACE.Results According to the results of coronary angiography,108 patients with CHD were divided into mild stenosis group 43 cases(39.81%),moderate stenosis group 51 cases(47.22%),and severe stenosis group 14 cases(12.96%).TCS score and Shemesh score were the highest in severe stenosis group,followed by moderate stenosis group,and the lowest in mild stenosis group(P<0.05).Kendall's tau-b(K) test showed that TCS score and Shemesh score were positively correlated with the degree of coronary artery stenosis(r=0.751,0.674,P<0.05).Pea rson correlation showed that TCS score of CHD patients was positively correlated with Shemesh sco re(r=0637,P<0.05).There was no significant difference in gender,age,BMI,course of disease,smoking history,diabetes,hypertension and dyslipidemia between MACE group and non-MACE group(P>0.05).The scores of NT-proBNP,TCS and Shemesh in MACE group were higher than those in non-MACE group(P<0.05).Logistic regression analysis showed that NT-proBNP,TCS score and Shemesh score were the risk factors for coronary hear

关 键 词：冠心病 冠脉狭窄程度 CT冠脉钙化积分 心血管不良事件 预测价值 

分 类 号：R541.4[医药卫生—心血管疾病]