冠状动脉慢性完全闭塞介入治疗中DSA机射线出束总剂量影响因素

Influencing factors for the radiation beam total dose of digital subtraction angiography equipment during the interventional procedure of chronic total occlusion of the coronary artery

目的探讨冠状动脉慢性完全闭塞(CTO)经皮冠状动脉介入治疗(PCI)中与DSA机射线出束总剂量相关因素。方法选取2021年9月至2022年9月南华大学附属第一医院收治的224例冠状动脉CTO患者为研究对象。根据射线出束总剂量将患者分为两组,<5 Gy为标准剂量组(n=173),≥5 Gy为超剂量组(n=51)。采用病例对照研究分析两组患者风险因素差异,并将P≤0.2风险因素纳入二元logistic回归分析,筛选出与超剂量(≥5 Gy)相关风险因素。结果J-CTO评分(OR=13.371,95%CI=2.784~64.231,P=0.001)、射线出束时长(OR=1.684,95%CI=1.133~2.504,P=0.010)与射线出束总剂量超量(≥5 Gy)显著相关。结论J-CTO评分及射线出束时长可预测CTO-PCI术中射线出束超剂量(≥5 Gy)。

Objective To investigate the factors that are related to the radiation beam total dose of digital subtraction angiography(DSA)equipment during percutaneous coronary intervention(PCI)for the treatment of chronic total occlusion(CTO)of the coronary artery.Methods A total of 224 CTO patients,who were admitted to the First Affiliated Hospital of University of South China to receive treatment,were enrolled in this study.According to the radiation beam total dose of DSA,the patients were divided into standard dose group(<5 Gy,n=173)and overdose group(5≥Gy,n=51).Using a case-control study to analyze the differential risk factors of the two groups,and the P≤0.2 risk factors were included in the binary logistic regression analysis to screen out the risk factors associated with overdose(≥5 Gy).Results The Japanese multicenter chronic total occlusion registry(J-CTO)score(OR=13.371,95%CI=2.784-64.231,P=0.001)and radiation beam duration(OR=1.684,95%CI=1.133-2.504,P=0.010)had a statistically significant relationship with the overdose(≥5 Gy)of radiation beam total dose.Conclusion J-CTO score and radiation beam duration can predict the overdose(≥5 Gy)of radiation beam total dose during PCI for CTO of the coronary artery.