高龄患者冠状动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

目的探讨高龄患者冠状动脉钙化情况及影响因素。方法回顾性分析该院247例80岁及以上高龄患者的临床资料,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)9例(3.94%),1分≤CS≤10分3例(1.32%),11分≤CS≤100分10例(4.39%),101分≤CS≤400分34例(14.91%),CS>400分为172例(75.44%)。与CS≤400组相比,CS>400组中,男性所占比例更大,病变血管支数较多,糖尿病所占比例更高,空腹血糖、低密度脂蛋白C(low density lipoprotein C,LDL-C)、血磷、超敏C反应蛋白(hypersensitivity c-reactive protein,hs-CRP)、血清胱抑素C及血尿酸浓度更高,高密度脂蛋白C(high density lipoprotein C,HDL-C)浓度更低,二组差异有统计学意义(P均<0.05)。结论高龄患者冠状动脉钙化发生率较高,钙化程度更严重;男性、病变血管支数多、糖尿病所占比例更高、空腹血糖增高、血清LDL-C增高、高血磷、高hs-CRP、高血清胱抑素C、高血尿酸浓度及HDL-C浓度降低均为高龄患者冠状动脉钙化的影响因素。

Objective To investigate the coronary artery calcification in elderly patients and its influencing factors. Methods Retrospective analysis of the clinical data was performed in author＇s hospital with 247 ca- ses of coronary heart disease at the age of 80 and above elderly patients. All patients underwent dual source spiral computed tomography （DSCT） coronary artery angiography and coronary calcification score （CS） were calculated. Results A total of 228（ 96. 06% ） patients had coronary calcification （TS〉0） ,in which 3 （ 1.32%） had mild coronary calcification （ 1 ≤CS≤ 10） , 10 （4. 39 0%） had moderate coronary calcification （11≤CS≤100） ,34 （14.91%） had moderate- severe coronary calcification （101≤CS≤400） ,172 （75.44%）had severe coronary calcification （CS〉400）. Compared with group with CS 400 ,the group with CS≤400 had higher ratio of male and type 2 diabetes, multi- vessels lesion around coronary artery, higher fasting blood glucose,low density lipoprotein C（LDL- C）, blood phosphorus, hypersensitivity c- reactive protein （hs- CRP）,serum cystatin C, serum uric aci, had lower high density lipoprotein C（ HDL- C）, the differ- ence between the two groups was statistically significant（P〈0.05）. Conclusions The incidence of coro- nary artery calcification is higher in elderly patients,and the degree of calcification is more serious. The risk factors of coronary calcification are male, diabetic, multi - vessels lesion around coronary artery, the increase of fasting blood glucose,LDL- C, blood phosphorus, hs- CRP, serum cystatin C, serum uric aci level and the decrease of HDL- C level.