COPD临床分级与CCTA冠状动脉粥样硬化狭窄程度的相关性研究

Study on the correlation between the clinical classification of COPD and coronary atherosclerosis based on CCTA

目的探讨COPD临床分级与基于CCTA的冠状动脉粥样硬化狭窄程度相关性。方法选取临床确诊的慢性阻塞性肺部疾病患者105例(所有患者均进行冠状动脉CT成像检查),根据肺功能检查结果分为轻、中、重度3组,采用GE Revolution CT行冠状动脉CT成像,所得原始数据传送至GE AW4.6工作站进行冠状动脉图像后处理,由两位有经验的医师对RCA、LCA和LAD共计954个冠脉节段(COPD轻度组549个节段、中度组216个节段、重度组189个节段)进行分析,对冠状动脉粥样硬化狭窄程度进行分析判断,采用卡方检验的统计学方法比较COPD临床分级与冠状动脉粥样硬化发生率、严重程度之间的相关性。结果冠状动脉粥样硬化程度与COPD临床分级有显著关系(P<0.05),冠状动脉粥样硬化狭窄程度与COPD临床分级有关联(P<0.05),COPD临床分级与冠状动脉粥样硬化发生率呈正相关性(P<0.05),随着COPD临床分级的升高,冠状动脉粥样硬化发生率逐渐增加,其发生率分别为25.87%、29.63%、37.04%;重度COPD组患者发生重度狭窄的比率高于其他2组,重度狭窄发生率分别为2.55%、1.39%、7.94%。结论COPD临床分级与冠状动脉粥样硬化狭窄程度呈正相关,对COPD患者早期进行临床干预,有助于预防冠状动脉粥样硬化的发生和加重。

Objective To investigate the correlation between the classification of chronic obstructive pulmonary disease(COPD)and coronary atherosclerosis(CAS).Methods 107 COPD patients suspected with cardiac artery disease were enrolled.According to the results of pulmonary function test,all patients were classified as mild,moderate and severe COPD(549 segments of mild,216 segments of moderate and 189 segments of severe).All the patients underwent CCTA with a 256-row wide-coverage volumetric CT(Revolution CT,GE healthcare,Milwaukee,WI).The raw images transmission to AW4.6 workstation for MPR and VR technique.Coronary artery lesions and stenosis were analyzed by two experienced physicians.The correlation was compared between the classification of COPD and the incidence and severity of CAS with Chi square test statistical method.Results Significant differences were observed between the classification of COPD and severity of CAS in three groups(P<0.05).COPD clinical classification was correlated significantly with the severity of CAS(P<0.05).Coronary atherosclerosis incidence increased gradually with the increase of COPD clinical classification(P<0.05),the incidence rates were 25.87%,29.63%and 37.04%.The incidence of severe stenosis in patients with severe COPD were higher than those in the other two groups.The incidence rates of severe stenosis were 2.55%,1.39%and 7.94%.Conclusion COPD clinical classification is correlated significantly with the severity of CAS.Early preventions and treatments of COPD should be helpful to prevent coronary atherosclerosis diseases.