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目的:通过分析冠状动脉粥样硬化相关因素与冠状动脉钙化积分的关系,探讨冠状动脉钙化发生机理。方法:选取湖北医药学院附属人民医院128层MDCT冠状动脉成像检查发现有冠状动脉钙化患者101例,采用传统的Agatston法计算其钙化积分,并检测所有患者血脂及肝肾功水平。通过logistic多元回归分析上述各项指标与冠脉钙化的相关性。结果:左前降支(LAD)冠脉钙化发生率最高,右冠状动脉(RCA)其次,左主干(LM)的发生率最低(P<0.01)。冠状动脉钙化积分与血浆脂蛋白a水平(P=0.002)、糖尿病(P=0.000)明显相关,冠状动脉钙化与年龄有相关性趋势,但无统计学意义(P=0.516)。分组研究显示女性糖尿病患者较女性非糖尿病钙化程度更高(63.6%比16.7%),有统计学意义(P=0.007)。结论:冠状动脉钙化积分与脂蛋白a、糖尿病有明显的相关性,脂蛋白a可能是冠状动脉钙化的一个独立预测因子,在2型糖尿病患者更为明显。
Objective: To explore the mechanism of coronary artery calcification by analyzing the relationship between coronary atherosclerosis related factors and coronary artery calcification score. Methods: A total of 101 patients with coronary artery calcification were examined by 128-slice MDCT coronary angiography in Affiliated People’s Hospital of Hubei Medical College. Calcium scores were calculated by the traditional Agatston method, and blood lipid, liver and kidney function were measured in all patients. Logistic multiple regression analysis of the above indicators and coronary calcium correlation. Results: The incidence of coronary artery calcification was highest in left anterior descending artery (LAD), followed by RCA followed by the lowest (P <0.01). Coronary artery calcification score was significantly associated with plasma lipoprotein a level (P = 0.002), diabetes (P = 0.000), and coronary artery calcification was related to age but not statistically significant (P = 0.516). Subgroup studies showed that women with diabetes had a higher degree of calcification than women without diabetes (63.6% vs. 16.7%) (P = 0.007). Conclusion: There is a clear correlation between coronary calcium score and lipoprotein a and diabetes. Lipoprotein a may be an independent predictor of coronary artery calcification, which is more obvious in type 2 diabetic patients.