冠状动脉钙化积分及相关临床因素对老年冠心病的诊断研究

Clincal study on coronary artery calcification score combined with some clinical factors in elderly patients with coronary artery disease

目的探讨多层螺旋CT冠状动脉钙化积分(CACS)及相关临床因素在老年冠心病诊断中的价值。方法入选疑诊冠心病患者106例,所有患者均行多层螺旋CT测量CACS、冠状动脉造影、外周血管彩超、心脏彩超以及相关血液生化检查。根据造影结果分为冠心病组62例(冠状动脉狭窄≥50%),非冠心病组44例(冠状动脉狭窄<50%),并对冠状动脉病变严重程度进行评分。结果与对照组相比,冠心病组CACS值明显升高,且CACS值随冠状动脉狭窄程度及病变严重程度加重而增加。冠心病组颈动脉内中膜厚度(IMT)、股动脉IMT、瓣膜钙化以及血压、血脂、空腹血糖、C-反应蛋白与非冠心病组相比,差异具有统计学意义。冠心病组中瓣膜钙化较非钙化者CACS值明显升高,差异具有统计学意义。结论 CACS值与外周血管彩超、心脏彩超和相关血液生化检查相结合,能更好的预测老年冠心病的发生、发展。

Aim To evaluate the clinical diagnostic value of coronary artery calcification score（CACS）of multi-slice spiral computed tomography（MSCT）combined with some clinical factors in elderly patients with coronary artery disease（CAD）.Methods 106 patients suspected of coronary artery disease were included.CACS of MSCT,coronary angiograohy,echosonography of intima media thickness（IMT）in carotid and femoral artery,UCG and blood biochemistry were performed in all patients,including 62 cases with CAD（CAD group）diagnosed by coronary angiography and 44 cases（control group）with coronary artery stenosis 〈50% stenosis.Three groups were graded according to the severity of coronary artery lesion.Results The coronary artery calcification score was significantly increased in CAD group compared with the control group,and it was increased with the severity of coronary arterial stenosis and the severity of coronary artery lesion.The IMT in carotid and femoral artery、valve calcification、blood pressure,TG,TC,LDL-C,HDL-C,FBG and C-reaction protion（CRP）in CAD group showed significant difference with that in control group.People with valve calcification had higher CACS than those without valve calcification in CAD group.Concultions CACS of MSCT combined with echosonography of IMT in carotid and femoral artery、UCG and blood biochemistry have good value in evaluating coronary artery disease in elderly patients.