冠状动脉造影中汉族人群体重指数与剂量面积乘积和透视时间相关性研究

Study on the relationship between body mass index and dose area product as well as fluoroscopy time in Han nationality during coronary angiography

目的研究汉族受检人群体重指数（BMI）与冠状动脉造影（CAG）检查辐射剂量面积乘积（DAP）值、透视时间相关性，早期判断和降低高辐射风险。方法回顾性分析451例汉族人群CAG患者资料，男276例，年龄32-87岁；女175例，年龄42—84岁；BMI值17．30～35．42kg／m^2。根据BMI值分为4组，A组25例（BMI〈20kg／m^2），B组204例（BMI20～24．9kg／m^2），C组192例（BMI25～29．9kg／m^2），D组30例（BMI〉30kg／m^2）。计算各组DAP和透视时间均值，采用非参数Kruskal-Wallis检验多重比较各组BMI患者DAP值，单因素方差分析或LSD-t检验比较各组BMI患者透视时间。结果DAP均值在A组为（1070．07±541．33）μGy／m^2，B组为（1326．82±606．91）μGy／m^2，C组为（1937．99±1030．31）μGy／m^2．D组为（2654．53±1296．69）μGy／m^2；透视时间均值在A组为（3．53±2．08）min，B组为（2．70±1．80）min，C组为（2．75±1．88）min，D组为（2．71±1．69）min。组间比较，除A组与B组间DAP值差异无统计学意义（P=0．232），余各组间差异均有统计学意义（P〈0．05）；A组与其它各组间透视时间差异均有统计学意义（P〈0．05），余各组间差异均无统计学意义（P〉0．05）。结论成年汉族受检人群CAG手术中DAP值随BMI增高而增加，透视时间在BMI〈20kg／m^2时明显延长。介入手术中不仅要了解BMI增高造成DAP值增加．更需特别关注BMI〈20kg／m^2时手术难度提高所致透视时间延长造成的DAP值增加。

Objective To investigate the relationship between body mass index （BMI） and dose area product （DAP） as well as fluoroscopy time during coronary angiography （CAG） in Han nationality subjects in order to improve early judging and reducing high radiation risk. Methods CAG materials of 451 Han nationality subjects were retrospectively analyzed. The patients included 276 males （age 32-87 years） and 175 females （age 42-84 years）, and the BMI values ranged from 17.30 to 35.42 kg/m^2. According to BMI values, the patients were divided into group A（BMI〈20 kg/m^2,n=25） ; group B （BMI 20-24.9 kg/m^2,n=204）, group C （BMI 25-29.9 kg/m^2,n=192） and group D （BMI〉30 kg/m^2,n=30）. The mean DAP and fluoroscopy time of each group were calculated; the DAP values were compared between each other among the four groups by using nonparametric Kruskal-Wallis test, while the fluoroscopy time was compared between each other among the four groups by using single factor analysis of variance or LSD-t test. Results The mean DAP of group A, B, C and D was（1 070.07±541.33） μGym^2, （1 326.82±606.91） μGym^2, （1 937.99±1 030.31） μGym^2 and （2 654.53±1 296.69） μGym^2 respectively. The mean fluoroscopy time of group A, B, C and D was （3.53± 2.08） min, （2.70±1.80） min, （2.75±1.88） min and （2.71±1.69） min respectively. Statistically significant difference in DAP values existed between each other among the four groups （P〈0.05） except between group A and group B （P=0.232）. Statistically significant difference in fluoroscopy time existed between group A and other three groups （P〈0.05）, while the difference in fluoroscopy time between each other among B, C and D groups was not significant （P〉0.05）. Conclusion The DAP values of adult Han subjects receiving CAG are increased with the increase of BMI values; the fluoroscopy time is significantly prolonged in patients with BMI 〈20 kg/m^2. In performing interventional procedure, the operator should not only understand that the increase of BMI can cause the increase of DAP, but also need to pay special attention to the increase of DAP value caused by operation difficulty when the patient＇s BMI is 〈20 kg/m^2. （J Intervent Radiol, 2015, 24： 763-766）