本文選題：X線計(jì)算機(jī)體層攝影術(shù) + 冠狀動(dòng)脈狹窄�。� 參考：《華北理工大學(xué)》2017年碩士論文

【摘要】：目的利用256層螺旋CT探討主動(dòng)脈彈性與冠狀動(dòng)脈狹窄程度、冠狀動(dòng)脈鈣化積分與狹窄程度、主動(dòng)脈彈性與冠狀動(dòng)脈鈣化積分的相關(guān)性。方法搜集華北理工大學(xué)附屬醫(yī)院2015年9月至2016年9月擬診為冠心病順利行冠狀動(dòng)脈CT血管造影(Coronary Artery Computed Tomography Angiography,CCTA)檢查病例,將圖像質(zhì)量能滿足主動(dòng)脈彈性測量的142例患者納為研究對象。根據(jù)CCTA結(jié)果,將研究對象分為無狹窄組(n=55)、狹窄組(n=87),狹窄組根據(jù)狹窄程度分為輕、中、重3組。根據(jù)冠狀動(dòng)脈有無鈣化分為鈣化陰性組(n=74)、鈣化陽性組(n=68),按照鈣化積分值大小將鈣化陽性組分為輕、中、重3組,按照CCTA結(jié)果進(jìn)一步將鈣化陰性組分為冠脈正常組、非鈣化斑塊組。重組升主動(dòng)脈5%-99.9%R-R間期間隔5%的圖像,采用AVA軟件自動(dòng)測量各R-R間期主動(dòng)脈橫截面積及直徑,計(jì)算評價(jià)主動(dòng)脈彈性的四個(gè)參考指標(biāo)直徑變化率(%A_0)、動(dòng)脈可擴(kuò)張度(A_0D,mm Hg-1)、動(dòng)脈順應(yīng)性(A_0C,mm2/mm Hg)及動(dòng)脈僵硬度(A_0SI)。同時(shí)記錄斑塊位置、病變支數(shù)并對狹窄程度進(jìn)行Gensini等級評分。分析主動(dòng)脈彈性與冠狀動(dòng)脈狹窄程度、冠狀動(dòng)脈鈣化積分與狹窄程度、主動(dòng)脈彈性與冠狀動(dòng)脈鈣化積分的關(guān)系。結(jié)果1無狹窄組%A_0:17.70±4.28、A_0D:2.82±1.32 mm Hg-1、A_0C:2.16±0.84mm2/mm Hg、A_0SI:3.05±1.12,狹窄組%A_0:13.29±3.96、A_0D:1.55±0.66 mm Hg-1、A_0C:1.34±0.47 mm2/mm Hg,A_0SI:4.79±1.93,兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。輕度狹窄組%A_0:14.77±4.56、A_0D:1.73±0.75 mm Hg-1、A_0C:1.45±0.45mm2/mm Hg、A_0SI:4.29±1.89;中度狹窄組%A_0:12.02±2.44、A_0D:1.44±0.53mm Hg-1、A_0C:1.34±0.50 mm2/mm Hg、A_0SI:5.24±1.93;重度狹窄組%A_0:11.27±2.25、A_0D:1.27±0.43 mm Hg-1、A_0C:1.06±0.35 mm2/mm Hg、A_0SI:5.43±1.80。輕、重度狹窄組間%A_0、A_0C、A_0SI比較有統(tǒng)計(jì)學(xué)差異(P0.05);輕、中度狹窄組間%A_0、A_0SI比較有統(tǒng)計(jì)學(xué)差異(P0.05);中、重度組間主動(dòng)脈彈性差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。Pearson相關(guān)分析顯示冠狀動(dòng)脈Gensini評分與%A_0、A_0D、A_0C呈負(fù)相關(guān)(r分別為-0.428、-0.361、-0.394,P0.05),與A_0SI呈正相關(guān)(r=0.404,P0.05)。主動(dòng)脈僵硬度影響因素的多元線性回歸分析顯示,年齡、脈壓、Gensini評分是主動(dòng)脈僵硬度的獨(dú)立影響因子。2冠狀動(dòng)脈正常組、輕、中、重度狹窄組平均鈣化積分分別為0,97.68±158.15,372.47±367.88,463.09±451.71,組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);冠狀動(dòng)脈鈣化積分與冠狀動(dòng)脈狹窄程度Gensini評分及病變支數(shù)均呈正相關(guān)(r分別為0.625、0.530,P0.01);不同狹窄程度組間冠狀動(dòng)脈四大主干鈣化積分比較,輕度狹窄右冠狀動(dòng)脈(Right coronary artery,RCA):10.09±18.57、左主干(Left main coronary artery,LM):2.51±6.17、左冠狀動(dòng)脈前降支(Left anterior descending,LAD):14.14±18.43、左回旋支(Left circumflex,LCX):1.26±2.39;中度狹窄RCA:48.09±55.98、LM:2.97±11.58、LAD:117.40±85.14、LCX:35.60±75.88;重度狹窄RCA:179.13±157.20、LM:20.25±77.00、LAD:403.15±256.59、LCX:120.29±154.73。除LM外,RCA、LAD、LCX比較差異有統(tǒng)計(jì)學(xué)意義(P0.01)。3鈣化陰性組%A_0:17.46±4.33、A_0D:2.56±1.29 mm Hg-1、A_0C:2.00±0.79 mm2/mm Hg、A_0SI:3.10±1.08,鈣化陽性組%A_0:12.32±3.22、A_0D:1.49±0.61 mm Hg-1、A_0C:1.28±0.47 mm2/mm Hg,A_0SI:5.21±1.93,兩組差異有統(tǒng)計(jì)學(xué)意義(P0.05);輕度鈣化組%A_0:13.33±4.16、A_0D:1.64±0.78 mm Hg-1、A_0C:1.34±0.48 mm2/mm Hg、A_0SI:4.79±1.80;中度鈣化組%A_0:11.81±2.87、A_0D:1.48±0.56 mm Hg-1、A_0C:1.30±0.50 mm2/mm Hg、A_0SI:5.57±2.11;重度鈣化組%A_0:12.05±2.44、A_0D:1.33±0.45 mm Hg-1、A_0C:1.17±0.42 mm2/mm Hg、A_0SI:5.01±1.76。鈣化陽性組輕、中、重三組間主動(dòng)脈彈性差異沒有統(tǒng)計(jì)學(xué)意義(P0.05)。冠脈正常組%A_0:18.72±3.85、A_0D:3.02±1.42 mm Hg-1、A_0C:2.24±0.86 mm2/mm Hg、A_0SI:2.83±0.98;非鈣化斑塊組%A_0:16.12±4.45、A_0D:2.07±0.93 mm Hg-1、A_0C:1.75±0.64 mm2/mm Hg、A_0SI:3.39±1.12,兩組間%A_0、A_0D、A_0C、A_0SI比較均有統(tǒng)計(jì)學(xué)差異(P0.05)。Pearson相關(guān)分析顯示%A_0、A_0D、A_0C與鈣化積分呈負(fù)相關(guān)(r分別為-0.336、-0.296,-0.308,P0.01),A_0SI與鈣化積分呈正相關(guān)(r=0.322,P0.01)。結(jié)論1主動(dòng)脈彈性指標(biāo)與冠狀動(dòng)脈狹窄程度呈正相關(guān),狹窄程度達(dá)中度以上,相關(guān)趨勢不明顯,主動(dòng)脈彈性可以作為早期冠心病診斷的敏感因子。2冠狀動(dòng)脈鈣化積分與狹窄程度及病變支數(shù)呈正相關(guān),鈣化積分可以作為冠心病評價(jià)的有效指標(biāo)。3主動(dòng)脈彈性與冠狀動(dòng)脈鈣化積分有相關(guān)性,兩者相結(jié)合,可以為臨床早期診斷冠心病提供影像學(xué)依據(jù)。
[Abstract]:Objective To study the relationship between aortic elasticity and coronary artery stenosis , coronary artery calcification score , stenosis degree , aortic elasticity and coronary artery calcification score by using 256 - slice spiral CT . The results showed that there were no stenosis group ( n = 55 ) , stenosis group ( n = 87 ) , and stenosis degree was divided into three groups : calcification negative group ( n = 74 ) , calcification positive group ( n = 68 ) . There was significant difference between the two groups ( P0.05 ) . There was a significant difference between the two groups ( P0.05 ) . - 0.361 , - 0.394 , P0.05 ) , positive correlation with A _ 0SI ( r = 0.404 , P0.05 ) . There was significant difference between coronary artery calcification score ( RCA ) : 10.09 鹵 18.57 , left main coronary artery ( RCA ) : 10.09 鹵 18.57 , left main coronary artery ( RCA ) : 14.14 鹵 6.17 , left main coronary artery ( LCX ) : 14.14 鹵 6.17 , left main coronary artery ( LCX ) : 14.14 鹵 6.17 , left main coronary artery ( LCX ) : 14.14 鹵 6.17 , left main coronary artery ( LCX ) : 10.09 鹵 18.43 , LCX : 20.25 鹵 77.00 , LAD : 403.15 鹵 256.59 , LCX : 120.29 鹵 154.73 . In addition to LM , RCA , LAD , LCX were statistically significant ( P0.01 ) . 2 . 56 鹵 1 . 29 mm Hg - 1 , A _ 0C : 2.00 鹵 0.79 mm2 / mm Hg , A _ 0SI : 3.10 鹵 1.08 , calcification positive group % A _ 0 : 12 . 32 鹵 3 . 22 , A _ 0D : 1 . 49 鹵 0 . 61 mm Hg - 1 , A _ 0 SI : 1 . 28 鹵 0 . 47 mm2 / mm Hg , A _ 0 SI : 1 . 28 鹵 0 . 47 mm2 / mm Hg , A _ 0 SI : 1 . 28 鹵 0 . 47 mm2 / mm Hg , A _ 0 SI : 5 . 21 鹵 2 . 87 , A _ 0D : 1 . 48 鹵 0 . 56 mm Hg - 1 , A _ 0 SI : 5.57 鹵 2.11 ; severe calcification group % A _ 0 : 12.05 鹵 2.44 , A _ 0D : 1.33 鹵 0.45 mm Hg - 1 , A _ 0C : There was no significant difference in aortic elasticity between the two groups ( P0.05 ) . Pearson correlation analysis showed that % A _ 0 , A _ D , A _ 0C were negatively correlated with calcification score ( r = - 0.336 , - 0.296 , - 0.308 , P0.01 ) , and A _ 0SI was positively correlated with calcification score ( r = 0.322 , P0.01 ) . Conclusion The aortic elastic index is positively correlated with the degree of coronary artery stenosis , the degree of stenosis is more than moderate , the related trend is not obvious , the aortic elasticity can be used as the sensitive factor for the early diagnosis of coronary heart disease . The calcification score can be used as an effective index for the assessment of coronary heart disease .

【學(xué)位授予單位】：華北理工大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541.4;R816.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 吳紅麗;孫洪濤;敖登其木格;趙宏森;;256層螺旋CT對冠狀動(dòng)脈狹窄的評估[J];心血管康復(fù)醫(yī)學(xué)雜志;2014年02期

2 徐磊;王輝;張楠;張兆琪;范占明;呂飚;于薇;;磁共振彈性成像評價(jià)主動(dòng)脈壁硬度[J];中國醫(yī)學(xué)影像技術(shù);2014年03期

3 田琪;金文仲;李海龍;牛愛原;;蒙古族與漢族冠狀動(dòng)脈鈣化斑塊分布與積分比較[J];醫(yī)學(xué)影像學(xué)雜志;2013年12期

4 王剛;吳依芬;張鎮(zhèn)滔;鄭曉林;;256層CTA技術(shù)在冠狀動(dòng)脈硬化狹窄診斷中的應(yīng)用價(jià)值[J];山東醫(yī)藥;2013年48期

5 劉芳;于晶;曹源;李桂娟;張顏蕾;伍建林;;雙源CT冠狀動(dòng)脈成像對升主動(dòng)脈彈性與冠狀動(dòng)脈狹窄程度的相關(guān)性研究[J];臨床放射學(xué)雜志;2013年10期

6 陳建軍;;多層螺旋CT冠狀動(dòng)脈鈣化積分在冠心病診斷中的應(yīng)用[J];中國實(shí)用醫(yī)藥;2013年26期

7 張惠英;陳偉彬;井淑艷;;256層螺旋CT對冠狀動(dòng)脈斑塊及管腔狹窄的診斷價(jià)值[J];中國煤炭工業(yè)醫(yī)學(xué)雜志;2013年09期

8 李麗;張洪;李鳳蓮;武永紅;;多層螺旋CT冠狀動(dòng)脈鈣化積分在冠心病診斷中的應(yīng)用[J];中國實(shí)用醫(yī)藥;2013年21期

9 王振威;王志銘;宋麗萍;王玉福;王晗;劉明;朱杰;褚建yN;;多層螺旋CT評價(jià)主動(dòng)脈彈性與冠狀動(dòng)脈斑塊性質(zhì)的相關(guān)性[J];解放軍醫(yī)學(xué)院學(xué)報(bào);2013年07期

10 梁文倩;成官迅;;動(dòng)脈彈性功能性影像學(xué)檢測方法的研究進(jìn)展[J];醫(yī)學(xué)研究雜志;2013年02期

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