MSCT评价冠心病患者降主动脉弹性与冠状动脉粥样硬化相关性

Relationship between Descending Aortic Distensibility and Coronary Atherosclerosis of CAD Patients Evaluated by MSCT

目的：利用64-MSCT评价冠心病患者降主动脉弹性与冠脉粥样硬化狭窄程度的相关性。方珐：对140例疑似冠心病的患者行冠脉CTA检查。使用GEAW4．4工作站重组降主动脉0-95％R-R间期间隔5％的图像，利用MATLAB软件勾画并测量各期相主动脉截面积，然后计算出主动脉弹性值。将受试者分为正常对照组（n=57）、无意义冠脉狭窄组（n=38）和有意义冠脉狭窄组（n=45）。主动脉弹性与冠脉狭窄积分相关性比较采用Spearman秩相关分析；使用多元线性回归分析包括主动脉弹性在内的与冠心病相关的各种独立影响因子。结杲：无意义冠脉狭窄组、有意义冠脉狭窄组降主动脉弹性值与冠脉狭窄积分均呈负相关（r=-0．709，P〈0．001；r=-0．565，P〈0．001）；多元线性回归表明，降主动脉弹性是冠脉狭窄积分的独立影响因子（B=-10．584，t=-4．066，P〈0．001）。结论：降主动脉弹性与冠脉狭窄程度具有负相关性，降主动脉弹性值D的评估有利于对冠脉粥样硬化程度的预测。

Objective To evaluate the relationship between descending aortic distensibility and the severity of coronary athero- sclerosis in coronary artery disease（CAD） patients by 64-slice computed tomography. Methods Total 140 patients suspected CAD were enrolled in this study and underwent computed tomographic arteriography（CTA）. The descending aortic images of 20 phases from 0% to 95% of the R-R intervals with an increment of 5% were reformatted by AW4.4 workstation and the images of aortic area were measured by MATLAB software, and then the aorta] distensibility was calculated. According to the severity of coronary stenosis, the patients were divided into normal subjects （ n = 57 ）, non-significant coronary stenosis sub- jects（ n = 38 ） and significant coronary stenosis subjects （n = 45 ）. The Spearman rank correlation was used to assess the rela- tionship between descending aortic distensibility and coronary stenosis integral. The independent CAD risk factors including aortic distensibility were analyzed with multivariate linear regression analysis. Results In the subjects of non-significant coro- nary stenosis and significant coronary stenosis, the aortic distensibility were negatively correlated with coronary stenosis inte- gral （ r = -0.709,P 〈 0.01, r = -0.565, P 〈 0.01, respectively）. Multivariate linear regression demonstrated that aortic dis- tensibility was the independent risk factor of coronary stenosis integral（ B = - 10.584, t = - 4. 066, P 〈 0.01 ）. Conclusion The aortic distensibility had a significant negative relationship with the degree of coronary stenosis. The evaluation of descend- ing aortic distensibility may play an important role in the prediction of coronary artery atheroselerosis.