南疆地区维吾尔族与汉族健康体检人群多层螺旋CT血管成像壁冠状动脉及其粥样硬化的比较

Assessment of coronary artery myocardial bridge and accompanied atherosclerosis in Uygur and Han adults of physical examination in southern Xinjiang region by using multi-slice spiral CT angiography

目的 分析南疆地区汉族及维吾尔族健康体检人群冠状动脉CT血管成像（CCTA）中壁冠状动脉（MCA）检出率、MCA合并粥样硬化检出率以及MCA发生部位及其差异.方法 回顾性分析2016年3月—2016年7月喀什地区第一人民医院3461例维吾尔族及汉族健康体检人群CCTA资料,其中维吾尔族1987例,男1267例、女720例,年龄25～79（48.43±10.61）岁;汉族1474例,男944例、女530例,年龄28～74岁（47.79±10.56）岁.采用双源螺旋CT进行CCTA,并进行曲面重建（CPR）、最大密度投影（MIP）及容积再现（VR）重组,比较汉族及维吾尔族人群MCA检出率、MCA合并粥样硬化检出率、MCA发生部位的差异.结果 3461例健康人群中,MSCT发现MCA 1111例,占32.10％（1111/3461）;其中汉族人群检出率为34.32％（506/1474）,维吾尔族人群检出率为30.45％（605/1987）,差异有统计学意义（χ^2=5.846,P〈0.05）.汉族人群组1474例中MCA伴发粥样硬化为136例、检出率为9.23％（136/1474）,维吾尔族人群组1987例中MCA伴发粥样硬化为268例、检出率为13.49％（268/1987）,有统计学意义（χ^2=14.902,P〈0.01）.壁冠状动脉1111例中,发生在左前降支的为1001例,占90.09％（1001/1111）,其中汉族432例,维吾尔族569例;发生在左回旋支为42例,占3.78％（42/1111）,汉族31例,维吾尔族11例;发生在第一对角支为55例,占4.95％（55/1111）,汉族37例,维吾尔族18例;发生在右冠状动脉5例,占0.45％（5/1111）,汉族3例,维吾尔族2例;发生2支以上的8例,汉族3例,维吾尔族5例,占0.72％;两族人群MCA发生部位差异有统计学意义（χ^2=26.522,P〈0.01）.结论 南疆地区维吾尔族、汉族健康体检人群CCTA显示的MCA检出率、MCA合并粥样硬化检出率以及MCA发生部位均存在差异.

Objective To analyze the incidence of mural coronary artery and the accompanied atherosclerosis in healthy Uygur and Han individuals in southern Xinjiang using coronary CT angiography （ CCTA） and the differences in the location of mural coronary artery. Methods CCTA data of 3461 Uygur and Han healthy people in the First People＇s Hospital of Kashgar from March 2016 to July 2016 including 1987 Uygurs, 1267 males and 720 females were retrospectively analyzed, with the age of 25 to 79 （48. 43 ± 10. 61） years, and 1474 Han subjects, 944 males and 530 females, aged 28 -74 （47. 79 ± 10.56） years. The CT reconstructing techniques including curved planar reformation （CPR）, maximum intensity projection （ MIP ） and volume rendering （ VR ） of the coronary arteries of each person were performed for detecting the incidence of mural coronary artery, and assessing the atherosclerosis accompanied by mural coronary artery as well as the distribution of mural coronary artery between Han and Uygur individuals. Results Among 3461 healthy subjects, mural coronary arteries occurred in 1111 by MSCT, accounting for 32. 10% （1111/3461）, including 506 Hans with an incidence of 34. 32% （506/1474）, and 605 Uygurs with the incidence of 30. 45% （605/1987）, and the incidence between two groups was statistically significant （χ^2 =5. 846, P 〈0. 05）. Among 1474 Hans, atherosclerosis was detected in proximal or distal segment of mural coronary arteries in 136 subjects, with an incidence of 9. 23%（136/1474）, while among 1987 Uygurs , totally 268 subjects suffered from this condition, with the incidence of 13. 49% （268/1987）, and the difference between the two groups was statistically significant （χ^2 =14. 902, P〈0. 01）. Among 1111 patients with mural coronary arteries, there were 1001 patients in the left anterior descending branch, accounting for 90. 09% （1001/1111）, including 432 Hans and 569 Uygurs. Moreover, there were 42 patients occurred in the left circumflex branch, accounting for 3. 78%（42/1111）, including 31 Hans and 11 Uygurs. There were 55 patients occurring in the first diagonal branch, accounting for 4. 95% （55/1111）, including 37 Hans and 18 Uygurs. There were 5 patients presenting in the right coronary artery, accounting for 0. 45% （5/1111）, including 3 Hans and 2 Uygurs. There were 8 patients with more than two arteries of atherosclerosis, including 3 Hans and 5 Uygurs, and the difference between two groups was statistically significant （χ^2 =26. 552, P〈0. 01）. Conclusions There are significant differences in the incidence of mural coronary arteries, atherosclerosis of mural coronary arteries, and distribution of mural coronary arteries between Uygur and Han healthy population in southern of Xinjiang region.