本文關(guān)鍵詞： 冠狀動(dòng)脈 起源異常 斑塊　出處：《遼寧醫(yī)學(xué)院》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 利用320排螺旋CT(血管成像)對(duì)冠狀動(dòng)脈起源異常患者進(jìn)行成像研究，通過(guò)CT成像及影像學(xué)表現(xiàn)來(lái)探討不同類型冠狀動(dòng)脈異常起源患者其粥樣硬化性斑塊的發(fā)生概率，為臨床提供相應(yīng)的診斷依據(jù)，從而預(yù)防臨床猝死事件的發(fā)生。 材料與方法 回顧性分析2009年12月至2011年5月在濟(jì)南軍區(qū)總醫(yī)院CT室成功行320排冠狀動(dòng)脈成像的6568例患者，其中共檢測(cè)出94例AOCA患者并對(duì)其進(jìn)行回顧性分析。全部患者均采用ToshibaAquilion one320排容積CT進(jìn)行冠狀動(dòng)脈成像，統(tǒng)計(jì)出不同類型冠狀動(dòng)脈起源的類型比例，并分析較大樣本類型AOCA對(duì)應(yīng)的血管粥樣硬化性斑塊的發(fā)病率。同時(shí)隨機(jī)抽取35名正常人群，作為對(duì)照組，并統(tǒng)計(jì)出正常人群每支冠狀動(dòng)脈粥樣硬化性斑塊的發(fā)生率，隨后應(yīng)用起源異常的相應(yīng)的血管其粥樣硬化性斑塊的發(fā)生率與正常人群對(duì)應(yīng)血管粥樣硬化斑塊發(fā)生率進(jìn)行χ2比較。對(duì)照組排除標(biāo)準(zhǔn)為患有冠狀動(dòng)脈異常起源患者。 結(jié)果 320排CT可以對(duì)心臟進(jìn)行快速容積掃描，從而快速得到容積數(shù)據(jù)，自2009年12月至2011年5月在濟(jì)南軍區(qū)總醫(yī)院CT室成功行320排冠狀動(dòng)脈成像的6568例患者共檢出94例AOCA患者。其發(fā)生率為1.43%，95例患者年齡為20～85歲，中位年齡為55.46歲，男性72例，女性22例，其中檢測(cè)出(1) RCA開(kāi)口高位例數(shù)14例，發(fā)生率為14.89%。(2) RCA開(kāi)口于左竇例數(shù)為36例，發(fā)生率為38.30%。(3) LM開(kāi)口高位例數(shù)為12例，發(fā)生率為12.77%。(4) LAD/LCX分別開(kāi)口于左竇(主干缺如)例數(shù)為23例，發(fā)生率為24.47%。(5) LCX起源于右冠例數(shù)為9例，發(fā)生率為9.57%。正常人群對(duì)應(yīng)的(1)LAD35人有14例有斑塊，發(fā)生率為40%。(2)LCX35例有6例，發(fā)生率為17.14%。(3)RAC35例有5例有斑塊，發(fā)生率為14.29%。后應(yīng)用異常起源患者其對(duì)應(yīng)的血管與正常人群相應(yīng)的血管進(jìn)行χ2比較。得出只有右冠起源于左竇時(shí)，右冠狀動(dòng)脈粥樣硬化性斑塊的發(fā)生率為41.47%，與正常人群右冠狀動(dòng)脈粥樣硬化性斑塊發(fā)生率14.29%相比，差異具有統(tǒng)計(jì)學(xué)意義（P0.05），其余均無(wú)統(tǒng)計(jì)學(xué)意義（P0.05） 結(jié)論 320排CT能夠成功的對(duì)心臟進(jìn)行容積掃描，它能夠清楚顯示血管及其走行，由以上數(shù)據(jù)得出大多數(shù)冠狀動(dòng)脈異常起源對(duì)粥樣硬化性斑塊沒(méi)有統(tǒng)計(jì)學(xué)意義，只有右冠起源于左竇時(shí)其（P0.05）具有統(tǒng)計(jì)學(xué)意義，在此建議應(yīng)同糖尿病、高血壓等一同列為粥樣硬化斑塊好發(fā)因素之一，當(dāng)檢查出AOCA尤其是右冠起源于左竇時(shí)應(yīng)格外注意，，從而指導(dǎo)臨床治療并預(yù)防急性冠狀動(dòng)脈綜合癥的發(fā)生。
[Abstract]:Purpose Patients with abnormal origin of coronary artery were studied with 320 slice spiral CT (angiography). To explore the probability of atherosclerotic plaques in patients with different types of abnormal origin of coronary artery by CT imaging and imaging findings, and to provide a basis for clinical diagnosis. In order to prevent the occurrence of clinical sudden death events. Materials and methods A retrospective analysis of 6568 patients who underwent 320 row coronary angiography in CT room of Jinan military region General Hospital from December 2009 to May 2011 was retrospectively analyzed. A total of 94 patients with AOCA were detected and analyzed retrospectively. All patients were performed coronary angiography with ToshibaAquilion one320 slice volume CT. The incidence of atherosclerotic plaques corresponding to large sample type AOCA was analyzed. 35 normal subjects were randomly selected as control group. The incidence of atherosclerotic plaque in each coronary artery in normal population was calculated. Then the incidence of atherosclerotic plaques in the corresponding vessels with abnormal origin was compared with that in the normal population. The exclusion criteria in the control group were the abnormal origin of coronary artery. Results A 320 slice CT scan of the heart can quickly obtain volume data by performing a rapid volumetric scan of the heart. From December 2009 to May 2011, a total of 94 cases of AOCA were detected in 6568 patients who underwent 320 row coronary angiography successfully in the CT room of Jinan military region General Hospital. The incidence rate was 1. 4. 3%. The age of 95 patients was 20 ~ 85 years old with a median age of 55.46 years. There were 72 males and 22 females. Among them 14 cases were detected with high RCA opening. The incidence of RCA opening in the left sinus was 36 cases, and the incidence rate was 38.30%. The incidence of LAD/LCX was 12.77%. The number of cases with LAD/LCX opening to the left sinus (absence of main trunk) was 23 cases. The incidence of LCX originated from the right corona in 9 cases and the incidence rate was 9.57.The incidence of LCX was 9.57.The plaque was found in 14 of the 35 normal subjects. The incidence of LCX35 was 40%, 6 cases were LCX, and the incidence was 17.14%. 5 cases had plaque. The incidence rate was 14.29.The corresponding blood vessels of the patients with abnormal origin were compared with the corresponding blood vessels of the normal population by 蠂 ~ 2. Only the right corona originated from the left sinus. The incidence of atherosclerotic plaque in the right coronary artery was 41.47, which was significantly higher than that in the normal group (14.29%, P 0.05). The rest had no statistical significance (P0.05). Conclusion 320 slice CT can successfully scan the heart volume, it can clearly show the blood vessels and their paths, from the above data we can conclude that most of the abnormal origin of coronary artery has no statistical significance for atherosclerotic plaque. Only the right corona originated from the left sinus (P0.05) has statistical significance. It is suggested that diabetes and hypertension should be one of the risk factors for atherosclerotic plaques. In order to guide clinical treatment and prevent the occurrence of acute coronary syndrome (ACS), we should pay special attention to the detection of AOCA, especially the origin of right coronary artery.
【學(xué)位授予單位】：遼寧醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R816.2

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本文編號(hào)：1462111