本文選題：HIV + 冠脈CTA�。� 參考：《鄭州大學(xué)》2017年碩士論文

【摘要】：第一部分 HIV感染患者冠脈斑塊和狹窄程度的評(píng)估研究目的:本研究通過觀察HIV感染患者和HIV非感染患者冠脈CTA的表現(xiàn),分析二者冠脈斑塊組成和管腔狹窄程度的異同點(diǎn)。材料與方法:收集2016年1月至2017年1月有癥狀的HIV感染患者21例和HIV非感染患者32例進(jìn)行冠脈CTA檢查,納入標(biāo)準(zhǔn):心肺肝腎功能良好,無碘對(duì)比劑過敏史,無心臟手術(shù)史,排除標(biāo)準(zhǔn):重度心肺肝腎功能不全,神志不清不能配合檢查,對(duì)碘對(duì)比劑過敏,有心臟手術(shù)史。結(jié)果:21名HIV感染患者和32名HIV非感染患者進(jìn)行了冠脈CTA檢查,按照15段分法,總共分別有297段和453段。HIV感染患者和HIV非感染患者的年齡分別為50.9±9.6和54.3±8.9,差異沒有明顯統(tǒng)計(jì)學(xué)意義。HIV感染患者和HIV非感染患者有斑塊的比例分別為15.6%和10.6%,p值為0.048,人均有斑塊的段數(shù)分別為2.2和1.5,差異具有統(tǒng)計(jì)學(xué)意義。HIV感染患者和HIV非感染患者發(fā)生軟斑塊的比例分別為8.8%和4.0%,p值為0.006,人均有軟斑塊的段數(shù)分別為1.2和0.6,差異有統(tǒng)計(jì)學(xué)意義。而HIV感染患者和HIV非感染患者發(fā)生混合斑塊的可能性之間沒有明顯差別。以個(gè)體為研究對(duì)象,HIV感染患者和HIV非感染患者發(fā)生軟斑塊的比例都較鈣化斑塊和混合斑塊高。對(duì)斑塊的位置分析,發(fā)現(xiàn)HIV感染患者和HIV非感染患者斑塊位于冠脈近段的比例分別為71.7%和72.6%,差異無統(tǒng)計(jì)學(xué)意義。HIV感染患者和HIV非感染患者發(fā)生明顯管腔狹窄(狹窄程度≥50%)的比例分別為7/21(33.3%)和2/32(6.3%),p值為0.028,二者之間的差異有統(tǒng)計(jì)學(xué)意義。在這7名有明顯管腔狹窄的患者中,發(fā)生明顯狹窄的比例為9/21(47.6%),其中右冠、左前降支和左回旋支發(fā)生管腔明顯狹窄的比例分別是1/9(11.1%)、6/9(66.7%)、和2/9(22.2%)。管腔有明顯狹窄的HIV感染患者和管腔沒有明顯狹窄的HIV感染患者發(fā)生不同性質(zhì)斑塊的比例相似,差異無統(tǒng)計(jì)學(xué)意義。在這7名管腔有明顯狹窄的HIV感染患者中,所有人都至少有2段冠脈有斑塊,而在其余14名HIV感染患者中,至少有2段冠脈有斑塊的患者占35.7%,p值為0.006,差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:HIV感染患者冠脈發(fā)生斑塊的可能性較HIV非感染患者高,尤其是軟斑塊,而發(fā)生混合斑塊的可能性沒有明顯差別。HIV感染患者冠脈發(fā)生中重度狹窄的可能性較HIV非感染患者高。第二部分 HIV感染患者冠脈斑塊影響因素的研究研究目的:通過對(duì)HIV感染患者斑塊的影響因素分析,判斷對(duì)斑塊影響較大的相關(guān)因素,從而進(jìn)行早期干預(yù)和及時(shí)治療。材料與方法:收集HIV感染患者21例,進(jìn)行冠脈CTA檢查,統(tǒng)計(jì)患者的基本信息和相關(guān)實(shí)驗(yàn)室檢查結(jié)果,根據(jù)CTA結(jié)果將HIV感染患者分為無斑塊組和有斑塊組。結(jié)果:HIV感染患者中無斑塊組較有斑塊組有著更高的CD4+T細(xì)胞檢查時(shí)(p=0.002)。CD4+T細(xì)胞檢查時(shí)和斑塊的數(shù)量明顯呈負(fù)相關(guān)(r=-0.66,p=0.001),而年齡、性別、BMI、高血壓、糖尿病、吸煙、低密度脂蛋白、高密度脂蛋白、甘油三酯、總膽固醇、抗病毒治療時(shí)間、CD4+T細(xì)胞最低點(diǎn)和斑塊的數(shù)量之間沒有相關(guān)性。結(jié)論:在HIV感染患者中,無斑塊組較有斑塊組有著更高的CD4+T細(xì)胞檢查時(shí)(p=0.002),CD4+T細(xì)胞檢查時(shí)和冠脈粥樣硬化斑塊的增多呈負(fù)相關(guān)。而其他相關(guān)因素在這個(gè)實(shí)驗(yàn)中沒有看到相關(guān)性,需要大樣本實(shí)驗(yàn)的進(jìn)一步研究。
[Abstract]:Part 1 Evaluation of coronary plaque and stenosis in patients with HIV infection. Objective: to analyze the similarities and differences of coronary plaque composition and stenosis degree between two patients with HIV infection and HIV non infected patients. Materials and methods: 21 patients with symptomatic HIV infection from January 2016 to January 2017 were collected and analyzed. HIV non infected patients with 32 cases of coronary CTA examination, included standard: good heart and lung liver and kidney function, no iodine contrast agent allergy history, no history of cardiac surgery, exclusion criteria: severe cardiopulmonary liver and kidney insufficiency, unconsciousness can not cooperate with examination, iodine contrast agent allergy, heart dirty hand history. Results 21 HIV infected patients and 32 HIV non infected patients entered. The coronary CTA examination was performed. According to the 15 segment method, the age of 297 and 453.HIV infected patients and HIV non infected patients were 50.9 + 9.6 and 54.3 + 8.9 respectively. There was no significant difference between.HIV and HIV non infected patients for 15.6% and 10.6%, and the p value was 0.048. The difference was 2.2 and 1.5, the difference was statistically significant in.HIV and HIV non infected patients, the proportion of soft plaques was 8.8% and 4%, P was 0.006, and the number of soft plaques per capita was 1.2 and 0.6, respectively. There was no significant difference between the possibility of mixed plaques in HIV infected patients and HIV non infected patients. The proportion of HIV infected patients and HIV non infected patients was higher than calcified plaques and mixed plaques. The position analysis of the plaque found that the proportion of HIV infected patients and HIV non infected patients in the proximal coronary segments were 71.7% and 72.6%, respectively, and there was no statistically significant difference in.HIV and HIV non infection patients. The proportion of obvious lumen stenosis (degree of stenosis more than 50%) in infected patients was 7/21 (33.3%) and 2/32 (6.3%), and the value of P was 0.028. The difference between the two were statistically significant. In the 7 patients with obvious lumen stenosis, the proportion of obvious stenosis was 9/21 (47.6%), and the right coronal, left anterior descending and left circumflex branch had obvious narrowing of the lumen. The narrow proportions were 1/9 (11.1%), 6/9 (66.7%), and 2/9 (22.2%). The proportions of different nature plaques in patients with obvious stenosis of HIV infection and that of HIV infected with no stenosis of the lumen were similar, and the difference was not statistically significant. In these 7 patients with clear stenosis of the lumen, all of them had at least 2 segments of coronary plaque. In the remaining 14 patients with HIV infection, at least 2 patients with coronary plaque were 35.7%, and the p value was 0.006. The difference was statistically significant. Conclusion: the possibility of coronary atherosclerotic plaque in patients with HIV infection is higher than that of non infected HIV patients, especially in soft plaque, and the possibility of mixed plaque is not significantly different from the incidence of coronary artery in patients with.HIV infection. The possibility of severe stenosis is higher than that of HIV non infected patients. Research on the influencing factors of coronary plaque in second part of HIV infected patients: by analyzing the influencing factors of plaque in patients with HIV infection, judging the relative factors that have great influence on the plaque, so as to make early intervention and time treatment. Materials and methods: collect HIV infected patients 21 CTA examination of coronary artery, the basic information of the patients and the results of the related laboratory examination, the patients with HIV infection were divided into no plaque group and plaque group according to the CTA results. Results: there was a higher CD4+T cell examination in the non plaque group of the patients with HIV infection (p= 0.002) when the.CD4+T cell examination and the number of plaques were obviously negative. Correlation (r=-0.66, p=0.001), and no correlation between age, sex, BMI, hypertension, diabetes, smoking, LDL, HDL, triglycerides, total cholesterol, antiviral treatment time, the lowest point of CD4+T cell and the number of plaques. Conclusion: in HIV infected patients, there is a higher CD4+T thinner in the plaque group than in the plaque group. There was a negative correlation between cell examination (p=0.002), CD4+T cell examination and the increase of atherosclerotic plaque in the coronary artery. Other related factors did not see the correlation in this experiment, and further study of large sample experiments was needed.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R512.91;R816.2

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 郝菲;竇勇;鄭曉明;王雅玲;;128層螺旋CT及斑塊分析軟件對(duì)冠脈斑塊成分的分析研究[J];中西醫(yī)結(jié)合心腦血管病雜志;2013年06期

2 陳文明;李東寶;;非罪犯冠脈斑塊研究的進(jìn)展[J];心臟雜志;2012年04期

3 倪廷樞,何國祥;定向冠脈斑塊旋切術(shù)的臨床進(jìn)展[J];國外醫(yī)學(xué).心血管疾病分冊(cè);1995年03期

4 章之川;高危和易損冠脈斑塊的命名[J];國外醫(yī)學(xué).心血管疾病分冊(cè);2004年06期

5 余國膺;;冠脈斑塊的成份[J];國外醫(yī)學(xué)情報(bào);1997年23期

6 顏國榮;馮毅;章曉國;;冠脈斑塊穩(wěn)定性的影響因素探討及預(yù)后的隨訪研究[J];現(xiàn)代醫(yī)學(xué);2012年01期

7 余;;人冠脈斑塊中的組織因子抗原[J];國外醫(yī)學(xué)情報(bào);1997年23期

8 余丹青,陳紀(jì)言,周穎玲,李光,羅建方,李瑜輝;冠脈斑塊穩(wěn)定性與腫瘤壞死因子相關(guān)研究[J];嶺南心血管病雜志;2002年05期

9 岳和全;;行PCI術(shù)的ACS病人強(qiáng)化抗血小板治療療效觀察[J];黑龍江醫(yī)藥;2009年03期

10 原杰;唐笑先;邵丹丹;陳克敏;;64層CT研究冠脈左主干分叉角與冠脈斑塊的相關(guān)性[J];上海交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2007年12期

相關(guān)會(huì)議論文 前3條

1 楊加臣;焦純;許健;張國鵬;張軍英;盧虹冰;;基于MAP-EM分割的冠脈斑塊定量檢測(cè)[A];第八屆全國信號(hào)與信息處理聯(lián)合學(xué)術(shù)會(huì)議論文集[C];2009年

2 高刃;佟林霞;;達(dá)芬奇手術(shù)機(jī)器人系統(tǒng)輔助下5例HIV感染患者卵巢囊腫剝除術(shù)手術(shù)護(hù)理配合[A];中華護(hù)理學(xué)會(huì)第16屆全國手術(shù)室護(hù)理學(xué)術(shù)交流會(huì)議論文匯編（上冊(cè)）[C];2012年

3 楊晶晶;張梅;張運(yùn);蔣桂花;;不同狹窄程度冠狀動(dòng)脈供血心肌節(jié)段同步性的研究[A];慶祝中國超聲診斷50年暨第十屆全國超聲醫(yī)學(xué)學(xué)術(shù)會(huì)議論文匯編[C];2008年

相關(guān)重要報(bào)紙文章 前1條

1 ;降壓藥可減緩冠脈斑塊進(jìn)展[N];中國醫(yī)藥報(bào);2004年

相關(guān)碩士學(xué)位論文 前10條

1 李振凱;640層動(dòng)態(tài)容積CT對(duì)血管密度比及冠脈斑塊鈣化積分的綜合評(píng)估研究[D];蘇州大學(xué);2015年

2 吳冠信;冠脈寧通方逆轉(zhuǎn)冠心病心絞痛患者（氣虛痰瘀互結(jié)證）冠脈斑塊的臨床研究[D];河南中醫(yī)學(xué)院;2015年

3 何善康;冠心病中醫(yī)“痰濁”證與冠脈斑塊組織學(xué)相關(guān)性研究[D];廣州中醫(yī)藥大學(xué);2016年

4 婁田田;基于虛擬組織聲像的冠心病痰瘀證候與冠脈斑塊特征性研究[D];廣州中醫(yī)藥大學(xué);2016年

5 張莉;紅細(xì)胞膜總膽固醇和冠脈斑塊穩(wěn)定性的相關(guān)性研究[D];蘇州大學(xué);2009年

6 石勝偉;冠脈斑塊穩(wěn)定性與炎癥因子及NF-κB的相關(guān)性研究[D];天津醫(yī)科大學(xué);2009年

7 乜麗;急性心肌梗死罪犯病變狹窄程度與預(yù)測(cè)因素分析[D];北京協(xié)和醫(yī)學(xué)院;2015年

8 苗振偉;能譜CT冠狀動(dòng)脈造影單能量圖像質(zhì)量優(yōu)化及狹窄程度評(píng)估的體模研究[D];天津醫(yī)科大學(xué);2015年

9 肖沖沖;64排螺旋CT冠狀動(dòng)脈成像對(duì)女性及男性冠狀動(dòng)脈狹窄診斷價(jià)值的對(duì)比[D];承德醫(yī)學(xué)院;2016年

10 王靜;冠心病患者抑郁與冠狀動(dòng)脈粥樣硬化的關(guān)系[D];華北理工大學(xué);2016年

，

本文編號(hào)：2086688