左冠状动脉前降支与回旋支夹角大于80°与夹角近段动脉粥样硬化的相关性

Correlation Between Coronary Bifurcation Angle ≥ 80° and Risk of Atherosclerosis in the Coronary Bifurcation Region Assessed by Coronary Computed Tomography Angiography

目的:分析左冠状动脉前降支与回旋支夹角(左冠状动脉夹角)以80°为切点时与左冠状动脉夹角近段动脉粥样硬化的相关性,探讨左冠状动脉夹角≥80°对该部位动脉粥样硬化的预测意义。方法:回顾性分析新疆维吾尔自治区6所医院1 276例行冠状动脉电子计算机断层摄影术(CT)血管造影(CTA)检查患者资料。按左冠状动脉夹角近段是否存在粥样硬化斑块,将年龄、血压、血糖、血脂、吸烟史、家族史、腰围/身高、左冠状动脉夹角≥80°纳入方程,按照不同性别分别进行Logistic回归分析。结果:左冠状动脉夹角近段有斑块患者中,左冠状动脉夹角≥80°的患者比例显著高于无斑块患者(男性:65.59%vs 54.21%,女性:56.64%vs 29.96%P<0.001)。多因素Logistic回归分析显示:与左冠状动脉夹角<80°的患者比较,左冠状动脉夹角≥80°的患者发生冠状动脉粥样硬化的风险较高(男性:OR=2.53,95%CI:1.76~3.64,P<0.001;女性:OR=5.33,95%CI:3.27~8.68,P<0.001)。结论:左冠状动脉夹角≥80°可作为影响左冠状动脉夹角近段粥样硬化斑块形成的独立危险因素。

Objectives： To investigate the correlation between coronary bifurcation angle ≥ 80° and atherosclerosis assessed by coronary computed tomography angiography（CCTA） in the coronary bifurcation region. Methods： The medical records from 1 276 patients undergoing CCTA in six hospitals of Xinjiang were retrospectively analyzed. The patients were divided into two groups according to the presence or absence of atherosclerosis in left coronary bifurcation angle region. Logistic regression analysis was performed to determine whether left coronary bifurcation angle ≥ 80° is an independent risk factor for coronary atherosclerosis in bifurcation angle region after adjustment for age, blood pressure, blood glucose, blood lipids, smoking history, family history as well as waist circumference/height ratio for male and female patients, respectively.Results： The proportion of patients with left coronary bifurcation angle ≥ 80° was significantly higher in atherosclerosis group than in non-atherosclerosis group（male：65.59% vs 54.21%; female：56.64% vs 29.96%, both P 0.001）. Logistic regression analysis showed that risk of developing coronary atherosclerosis in corresponding region was significantly higher in patients with left coronary bifurcation angle ≥ 80° than those with angle80°（male：OR=2.53, 95%CI：1.76~3.64, P〈0.001; female： OR=5.33, 95%CI： 3.27~8.68, P〈0.001）.Conclusions： Left coronary bifurcation angle ≥ 80° is an independent risk factor for coronary atherosclerosis in this region.