冠状动脉介入治疗中不同病变类型辐射剂量比较

Comparison of Radiation Dose of Different Types of Lesions in Coronary Intervention

目的:比较经皮冠状动脉介入治疗(Percutaneous Coronary Intervention,PCI)中A型病变和非A型病变的辐射剂量差异。方法:纳入2020年7月至2021年7月期间在重庆医科大学附属第一医院行PCI治疗的110例患者,根据病变类型将患者分为A型病变组和非A型病变组,统计并比较空气比释动能(Air Kerma)、剂量-面积乘积(Dose-area product,DAP)、透视时间(Fluoroscopy Time,FT)、造影时间(Acquisition Time,AT)等辐射剂量相关参数的差异,用多元线性回归分析辐射剂量的危险因素。结果:A型病变组的Air Kerma(268.3±144.6 vs.660.2±540.1mGy,P<0.01)、DAP(17743.0±9402.2 vs.42350.6±33078.2 mGy·cm^(2),P<0.01)、FT(714.8±330.4 vs.1406.3±840.2s,P<0.01)、AT(52.8±12.7 vs.76.8±25.9s,P<0.01)均低于非A型病变组。多元线性回归得出辐射剂量的危险因素包括年龄、支架总长度、病变类型(P<0.01)。结论:PCI中非A型病变辐射剂量明显高于A型病变。在复杂PCI中术者更应注意自身的辐射防护。

Objective:To compare the radiation dose difference between type A lesions and non-A-type lesions in percutaneous coronary intervention(PCI).Methods:Include 110 patients who underwent PCI treatment in the First Affiliated Hospital of Chongqing Medical University from July 2020 to July 2021.According to the type of lesions,the patients were divided into type A lesions group and non-A type lesions group,and counted and compared Air Kerma,Dose-area product(DAP),Fluoroscopy Time(FT),Acquisition Time(AT)and other radiation dose-related parameters,and multiple linear regression is used to analyze the risk factors of radiation dose.Results:Air Kerma(268.3+144.6 vs.660.2±540.1 mGy,P<0.01),DAP(17743.0±9402.2 vs.42350.6±33078.2 mGy·cm^(²),P<0.01),FT(714.8±330.4 vs.1406.3±840.2s,P<0.01)AT(52.8±12.7 vs.76.8±25.9s,P<0.01)in type A lesions group were significantly lower than those of the non-A-type lesions group.Multivariate linear regression showed that the risk factors of radiation dose included age,total length of the stent,and type of lesion(P<0.01).Conclusion:The radiation dose of non-A-type lesions in PCI is significantly higher than that of type A lesions.In complex PCI,surgeons should pay more attention to their own radiation protection.