老年患者冠脉钙化情况及影响因素分析

Analysis of the Status of Coronary Artery Calcification and Its Influencing Factors in Elderly Patients

目的探讨无冠心病史的老年患者冠脉钙化情况及影响因素。方法收集本院无冠心病史的92例老年患者的临床资料,采用双源多层螺旋CT(Dual-source spiral computed tomography,DSCT)进行冠状动脉造影,计算钙化积分(Calcification score,CS)。结果无冠脉钙化(CS 0分)3例(3.26%),0分<CS≤100分37例(40.22%),CS 101～400分12例(13.04%),CS>400分为40例(43.48%);与CS≤400组相比,CS>400组年龄偏高(80.50±6.59岁VS 83.40±4.08岁),男性更多(69.23%VS 90.00%),糖尿病比例更高(19.23%VS 45.00%),空腹血糖(5.34±0.92 mmol/L比5.78±1.19 mmol/L)、血清同型半胱氨酸(Homocysteine,Hcy)浓度(13.16±5.23μmol/L VS 17.00±6.68μmol/L)更高(P均<0.05)。结论无冠心病史老年患者冠脉钙化发生率高,冠脉钙化的影响因素有年龄、男性、糖尿病、空腹血糖以及Hcy升高。

Objective To investigate the coronary calcification and the risk factors in elderly patients without the history of coronary artery diseases. Methods The clinical data of 92 enrolled patients without coronary artery diseases were collected. All patients underwent dual source multi-detector row computed tomography （MDCT） coronary artery anglography and coronary calcification score （CS） were calculated. Results 89 （96.7%） patients had coronary calcification （TS 〉0）, in which 37 （40. 2% ） had mild coronary calcification （0 〈 CS≤ 100 ）, 12 （ 13.0% ） had moderate coronary calcification （ 100 〈 CS ≤400） and 40 （43.5 % ） had severe coronary calcification （ CS 〉 400）. Compared with group with CS ≤ 400, the group with CS 〉 400 was older （ 80. 50 ± 6. 59 years vs 83.40 ± 4. 08 years, P = 0. 016）, had higher ratio of male （69. 2% vs 90%, p = 0. 005 ） and type 2 diabetes （ 19. 2% vs 45%, p = 0. 037 ）, had higher fasting blood glucose and serum homocysteine （Hcy） （ 13.16 ±5.23μmol/L vs 17.00 ± 6. 68μmol/L, p = 0. 003 ）. Conclusion The elderly patients without history of coronary artery diseases had higher prevalence of coronary calcification, the risk factors of coronary calcification were old age, male, diabetic, the increase of fasting blood glucose and Hey Level.