本文關鍵詞： 危險因素 冠心病 多排螺旋CT　出處：《南方醫(yī)科大學學報》2012年10期 　論文類型：期刊論文

【摘要】：目的 Framingham計分是公認的估計心血管風險的方法,但是其預測的準確性一直有爭論。冠脈CT診斷斑塊有很高的準確性,本研究擬將冠脈CT斑塊與Framingham危險因素進行對照研究,分析各危險因素預測冠脈斑塊的準確性。方法連續(xù)入選核醫(yī)學科2008年6月~2011年4月行64排螺旋CT的門診和住院病人共706例。冠脈CT病變嚴重程度分為正常、輕度、中度、重度、支架或搭橋術后5類,將冠心病危險因素與冠脈CT進行相關分析,包括方差分析,Pearson相關和ROC曲線分析。結果正常冠脈CT占40.37%,異常冠脈CT占58.63%。高齡,高血壓、高血脂癥、糖尿病、臨床診斷腦梗死、冠心病,心肌梗死患者冠脈CT斑塊的比率明顯高于正常冠脈CT組,差異顯著,而且發(fā)生率隨著病變程度加重而升高(P0.05)。臨床診斷為冠心病的患者,冠脈CT正常22.5%,而冠脈CT異常77.5,差異顯著(P0.05)�？偰懝檀�、低密度脂蛋白、高密度脂蛋白、尿素、肌酐與冠脈CT斑塊明顯相關,差異顯著(P0.05)。甘油三酯,尿素氮,尿蛋白,尿酸,空腹血糖,全血糖化血紅蛋白,血紅蛋白,血清肌鈣蛋白T,左室舒張末內徑,左室射血分數(shù)等危險因素與冠脈斑塊不相關(P0.05)。Pearson相關顯示,危險因素與斑塊相關。ROC曲線可見Framingham計分,肌酐,同型半胱氨酸和頸動脈內膜厚度預測冠脈斑塊的準確性較高(P0.05)。結論冠心病危險因素與冠脈CT斑塊明顯相關,其中Framingham積分、肌酐、同型半胱氨酸和頸動脈內膜厚度相關最為密切,可以作為冠心病的一般篩查。
[Abstract]:Objective Framingham scoring is a recognized method for estimating cardiovascular risk, but the accuracy of its prediction has been disputed. Coronary CT diagnosis of plaque has a high accuracy. The aim of this study was to compare the risk factors of coronary CT plaque with Framingham. Methods A total of 706 outpatients and inpatients who underwent 64-slice spiral CT from June 2008 to April 2011 were enrolled in the department of nuclear medicine to evaluate the accuracy of predicting coronary plaque. The severity is divided into normal. The risk factors of coronary artery disease (CHD) were correlated with coronary CT, including analysis of variance (ANOVA). Results normal coronary CT accounted for 40.37%, abnormal coronary CT 58.63%. Old age, hypertension, hyperlipidemia, diabetes mellitus. The ratio of coronary artery CT plaque in patients with cerebral infarction, coronary heart disease and myocardial infarction was significantly higher than that in normal coronary CT group. The incidence of coronary CT was 22. 5 normal in patients with coronary heart disease and abnormal 77.5 in coronary CT. Total cholesterol, low density lipoprotein, high density lipoprotein, urea and creatinine were significantly correlated with coronary CT plaques. Urine protein, uric acid, fasting blood glucose, whole blood glycosylated hemoglobin, hemoglobin, serum troponin T, left ventricular end-diastolic diameter. Left ventricular ejection fraction (LVEF) and other risk factors were not associated with coronary plaque (P0.05N). Pearson correlation showed that the correlation between risk factors and plaque. ROC curve showed Framingham score. Creatinine, homocysteine and carotid intimal thickness were more accurate in predicting coronary plaque (P 0.05). Conclusion Coronary heart disease risk factors are significantly correlated with coronary artery CT plaque. Framingham scores, creatinine, homocysteine and carotid intima thickness are most closely related, and can be used as a general screening for coronary heart disease.
【作者單位】： 解放軍總醫(yī)院心內科;解放軍總醫(yī)院核醫(yī)學科;
【基金】：國家自然科學基金(30872204,30400367,81071378) 國家十一五科技支撐計劃(2006BAI01A02) 國家留學基金(留金發(fā)[2010]3009號)~~
【分類號】：R541.4
【正文快照】： 與西方發(fā)達國家不同,根據(jù)中國心血管中心的報告,我國心血管疾病呈明顯上升趨勢[1]。已經有大量的流行病學的資料證實,應該在無癥狀時給予干預,糾正和改變危險因素。Framingham研究通過隨訪對相對健康的患者得出實際事件率,并以簡單的數(shù)個危險因素預測冠心病的長期危險,但是其

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本文編號：1460069