64层CT评估冠状动脉侧支循环及侧支循环形成的影响因素分析

Assessment of coronary collateral circulation by 64-slice CT and significant factor effecting the formation of collateral circulation

目的评价64层CT判断冠状动脉形成的准确性,分析影响冠状动脉侧支循环形成的主要因素。方法回顾性分析经64层螺旋CT冠状动脉成像发现至少一支冠状动脉主要分支狭窄程度≥90%的73位患者影像资料,评价其是否存在冠状动脉侧支循环,以73位患者的CAG影像为金标准,判断64-MSCT检出冠状动脉侧支循环的准确性。收集73位患者的性别、年龄、冠心病病史、高血压、高血脂及糖尿病病史,吸烟、饮酒状况等临床资料,采用Logistic回归分析判断影响冠状动脉侧支循环形成的显著性因素。结果以CAG为金标准,64-MSCT检出患者发生冠状动脉侧支循环的敏感性为82.4%(28/34),特异性为94.9%(37/39)。采用Logistic回归分析,结果显示冠心病病史的长度及高血脂是影响冠状动脉侧支循环形成的显著性因素,P值分别为0.039和0.036,偏回归系数B值分别为0.122和-1.286,即冠心病病史较长或没有高血脂病史的患者更容易出现冠状动脉侧支循环。结论64-MSCT可以较准确的检出冠状动脉侧支循环,冠心病病史和高脂血症是影响冠状动脉侧支循环形成的显著性因素。

Objective To evaluate the accuracy of 64-slice CT of detecting the coronary collateral circulation（CCC）, and to analyze the major factors effeeting the formation of CCC. Methods Analyzed retrospectively 73 patients＇ imaging of 64-slice spiral CT coronary angiography, which manifested at least one major coronary artery with stenosis greater than 90%. Taking traditional coronary angiography （CAG） as the reference standard, we evaluated the accuracy of the 64-slice CT to detect the CCC. We retrospectively collected all these patients＇ clinical information, such as gender, age, duration of coronary heart disease （CHD）, hypertension, hyperlipoidemia, diabetes, and decided the significant factors which effected the formation of CCC by the binary Logistic regression. Results Taking the CAG as the reference standard, the sensitivity and specificity of 64-slice CT for detecting the CCC was 82. 4% （28/34） and 94.9%（37/39）. By the binary Logistic regression, the significant factors effecting the formation of CCC were duration of CHD and hyperlipoidemia, the P values of Logistic regression were 0. 039 and 0. 036, and the B values were 0. 122 and -1. 286. Conclusions 64-slice CT could accurately detect the coronary collateral circulation. The significant factors effecting the formation of CCC were duration of CHD and hyperlipoidemia.