50～70岁人群心脏瓣膜钙化与冠状动脉粥样硬化的关系浅析

Correlation of heart valve calcification and coronary atherosclerosis in 50-to 70-year-old adults

目的：探讨50～70岁年龄段人群钙化性瓣膜病与冠状动脉粥样硬化的关系，试图在冠状动脉粥样硬化引发症状前提供预警。方法选取2010年1月至2015年6月在解放军总医院行冠状动脉造影或冠状动脉CT血管造影（ CTA）检查的年龄50～70岁的患者205例，经超声心动图检查，分为钙化组（n＝107）和非钙化组（n＝98）。对两组患者血压、血糖、血脂数据进行对比分析，两组患者冠心病发病率及狭窄血管病变程度与主动脉瓣膜钙化进行相关性分析。结果瓣膜钙化组高血压、高脂血症和糖尿病发生率均显著高于非钙化组，差异具有统计学意义（P＜0．05），两组患者除高密度脂蛋白胆固醇无明显差异外，瓣膜钙化组的血压（包括收缩压及舒张压）、总胆固醇、低密度脂蛋白胆固醇、甘油三酯、空腹血糖均高于非钙化组，差异具有统计学意义（ P＜0．05）。瓣膜钙化组冠心病发生率高达64．49％，其中冠状动脉单支病变为42．99％，2支冠状动脉病变者13．08％，≥3支冠状动脉病变者为8．41％，而非钙化组冠心病发生率仅17．35％，且大多数为单支病变。无论冠心病总发病率，还是冠状动脉狭窄血管支数，瓣膜钙化组均明显高于非钙化组，差异具有统计学意义（P＜0．01）。结论心脏瓣膜钙化与冠状动脉狭窄有相关性，心脏瓣膜钙化可简便、有效地筛选需进一步接受冠状动脉CTA或冠状动脉造影检查的患者。

Objective To investigate the correlation of heart valve calcification with coronary atherosclerosis in the adults at the age of 50-70 years in order to provide early warning before the symptom appearance induced by atherosclerosis .Methods Totally 205 subjects who underwent coronary artery angiography or coronary computed tomographic angiography （CTA） in our hospital from January 2010 to June 2015 were recruited in this study .According to the results of echocardiography , they were divided into calcification group （ n=107） and non-calcification group （ n =98 ） .The blood pressure , blood glucose level and lipid profiles were measured and compared between the 2 groups.The correlations of the incidence of coronary heart disease and severity of coronary artery lesions were analyzed with heart valve calcification .Results The patients in calcification group had significantly higher incidences of hypertension , diabetes and hyperlipemia than those of non-calcification group （P〈0.05）.Except for high-density lipoprotein cholesterol （HDL-C）, systolic blood pressure （ SBP ） , diastolic blood pressure （ DBP ） , total cholesterol , low-density lipoprotein cholesterol （ LDL-C ） , triglycerides （ TG ） , and fasting plasma glucose were obviously higher in calcification group than in non -calcification group （P〈0.05）.The incidence of coronary artery disease was 64.49%in calcification group, with 42.99%of single vessel, 13.08%of 2 vessels, and 8.41%of≥3 vessels of coronary artery lesions.However, in non-calcification group, the incidence of coronary artery disease was only 17.35%, and most of them were single vessel lesion .Both the incidence of coronary artery disease and the involved vessels of coronary artery lesions were remarkably higher in calcification group than in non-calcification group （P〈0.05）.Conclusion Heart valve calcification and coronary artery lesions are correlated .Investigation of heart valve calcification is an easy, fast and effective method to screen the patients needing for CTA or coronary artery angiography .