冠状动脉钙化在肥厚型心肌病诊断中的临床意义

Clinical Implications of Coronary Artery Calcification in Patients with Hypertrophic Cardiomyopathy by Electron-Beam CT Scanning

评价冠状动脉钙化在肥厚型心肌病鉴别诊断中的临床价值。连续调查了 99例 30岁以上临床确诊肥厚型心肌病患者资料 ,分析其年龄、性别分布和冠状动脉钙化特点 ,并与同期同年龄段冠心病患者资料进行对比。结果发现 ,99例肥厚型心肌病患者的冠状动脉钙化积分与钙化阳性率随年龄增加而增加 ,存在性别差异 ,钙化总积分和钙化阳性率分别是 2 1.1± 4 .9和 32 .3% ,均显著低于冠心病组 (2 0 3.2± 34.9和 6 6 .7% ;P <0 .0 1) ;但仍在国人正常的钙化积分切点范围内。调整性别、年龄因素后 ,肥厚型心肌病患者的冠状动脉钙化积分和钙化阳性率仍显著低于冠心病组 (P <0 .0 1)。结果提示 ,电子束CT检测冠状动脉钙化有助于疑似或合并冠心病的肥厚型心肌病患者的鉴别诊断 ,具有重要的临床价值。

Aim To determine whether electron-beam CT (EBCT) is useful as a noninvasive coronary artery calcification screening examination for differentiating diagnosis of hypertrophic cardiomyopathy (HCM). Methods Ninety and nine consecutive patients with HCM from 33 to 71 years old (48.6±12.7 years), were reviewed to find out clinical characteristics and implication of coronary artery calcification detected with EBCT scanning when simultaneously compared with 102 coronary heart diseases (CHD) patients, 30 to 78 years old (56.2±10.9 years). Results Of the 99 HCM patients, 31 (32.3%) had detectable coronary calcification, and calcium score was 21.1±4.9. There was a significant difference between HCM group and CHD group, which were 66.7%(68/102) and 203.2±34.9, respectively (P<0.01). The prevalence of coronary calcification and calcium score had a increase as age went up in HCM patients, but still in the range scores in normal chinese. The outcome was the same after age and gender adjustment. Conclusion EBCT is helpful to distinguish HCM patients from suspected CHD patients or associated CHD as a noninvasive imaging technique.