冠状动脉钙化与冠状动脉病变的多因素相关性 CAC与缺血心肌罪犯血管及梗死相关血管的结果  

The multiple correlation of coronary calcification and coronary stenosis

作　　者：彭夫松[1] 李瑞杰[1] 任文林[1] 陈玻[1] 

机构地区：[1]北京市垂杨柳医院心内科,北京市100022

出　　处：《中国临床康复》2003年第9期1364-1365,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的通过对怀疑冠状动脉性心脏病患者行X线透视和冠状动脉造影检查,探讨冠状动脉钙化与冠状动脉血管病变的关系。方法360例怀疑冠状动脉性心脏病患者行冠状动脉造影时,以X光透视检测冠状动脉钙化的有无。男218例,平均年龄(54.2±12.8)岁;女142例,平均年龄(58.5±10.1)岁。根据冠状动脉造影血管狭窄程度分成3组,A组:冠状动脉内径狭窄≥50%192例,B组:血管内径狭窄<50%103例(29%);C组:无明显狭窄65例。结果68例X线透视下可见冠状动脉钙化(CAC),其中男患者42例、女患者26例(18%),无明显性别差异(χ2=1.02,P>0.05)。A组29.2%(56/192)、B组9.7%(10/103)、C组2%(1/65)可见钙化影,各组间存在极显著差异(χ2=12.38,P<0.001)。所有68例冠状动脉钙化患者中,50岁以下3%(2/65)、50～59岁10%(9/89)、60～69岁22%(30/138)、70岁及以上40%(27/68)。各年龄组间差异显著(χ2=7.56,P<0.01)。AMI组28%(10/36)可见钙化影,其中8例(80%)为梗死相关血管,陈旧性心肌梗死33%(8/24)可见钙化影,其中7例(88%)为梗死相关血管,疑慢性稳定型心绞痛39例出现血管狭窄,55%(23/42)可见钙化影,18例(78%)疑为罪犯血管,疑不稳定型心绞痛(UA)93例(36%)出现血管狭窄,27%(25/93)可见钙化影,20例(80%)疑为罪犯血管。急性心肌梗死(AMI)。Aim To study the correlation of coronary calcification and coronary stenosis.Methods 360 cases with 218 male,aged (54.2± 12.8) years and 142 female,aged (58.5± 10.1) years of suspected coronary heart disease were tested with X ray fluoroscopy while making coronary angiography.All the patients were divided into 3 groups according to the results of angiography. group A: 192 cases( 53.3% ) with ≥ 50% coronary stenosis of diameter,55 cases with mono ramus lesion, 93 cases with bi ramus lesion and 44 case with tris ramus lesion. group B: 103 ( 28.6% ) cases with < 50% coronary stenosis of diameter; group C: 65 cases ( 18.1% ) no significant coronary stenosis.Results 68 cases ( 18.8% ) revealed CAC through X ray fluoroscopy.There were 42 cases ( 19% ) of male patients and 26 cases of female patients(18% ) with significant CAC, there was no significance between the two groups (χ 2=1.02,P >0.05). 29.2% ( 56/192) in A group, 9.7% ( 10/103) in B group and 1.5% ( 1/65) in C group revealed CAC, There were significance between every two groups.All of the 68 cases with CAC,3% ( 2/65) under 50 old age,10% ( 9/89) 50- 59, 22% ( 30/138) 60- 69, 40% ( 27/68) older than 70. CAC has been revealed in 28% of patients with AMI, 8 cases( 80% ) were suspected infarction correlated vessels, in 33% ( 8/24) of patients with old myocardial infarction,7 cases ( 88% ) were suspected infarction correlated vessels, in 55% ( 23/42) of suspected chronic stable angina,18 cases( 78% ) were suspected culprit vessels. 93 cases ( 36% ) of suspected unstable angina were demonstrated to be with significant coronary stenosis, in 27% ( 25/93) of patients revealed CAC, and 20 cases ( 80% ) were suspected culprit vessels. There were no significance between AMI, old myocardial infarction and unstable angina in CAC( χ 2=2.18,P >0.05) , but there were significance between chronic stable angina and each of the other groups( χ 2=6.82,P< 0.01) . Conclusion CAC is correlated with age and coronary stenosis closely.There is no signific

关 键 词：冠状动脉钙化 冠状动脉病变 冠状动脉造影 冠状动脉性心脏病 X线 心肌梗死 CAC 梗死相关血管 心肌缺血 罪犯血管 血管狭窄 

分 类 号：R542.22[医药卫生—心血管疾病] R541.4[医药卫生—内科学]