南方医科大学学报

南方医科大学学报 ›› 2012, Vol. 32 ›› Issue (10): 1400-.

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冠状动脉CT与冠心病危险因素的相关分析

何斌，盖鲁粤，盖兢泾，乔怀宇，张朔阳，关志伟   

  • 出版日期:2012-10-20 发布日期:2012-10-20

Coronary plaques identified by coronary computed tomography angiography and the risk factors for major adverse cardiac events: a correlation analysis

  • Online:2012-10-20 Published:2012-10-20

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摘要： 摘要：目的Framingham计分是公认的估计心血管风险的方法，但是其预测的准确性一直有争论。冠脉CT诊断斑块有很高的
准确性，本研究拟将冠脉CT斑块与Framingham危险因素进行对照研究，分析各危险因素预测冠脉斑块的准确性。方法连续
入选核医学科2008年6月~2011年4月行64排螺旋CT的门诊和住院病人共706例。冠脉CT病变严重程度分为正常、轻度、中
度、重度、支架或搭桥术后5类，将冠心病危险因素与冠脉CT进行相关分析，包括方差分析，Pearson相关和ROC曲线分析。结
果正常冠脉CT占40.37%，异常冠脉CT占58.63%。高龄，高血压、高血脂症、糖尿病、临床诊断脑梗死、冠心病，心肌梗死患者
冠脉CT斑块的比率明显高于正常冠脉CT组，差异显著，而且发生率随着病变程度加重而升高（P<0.05）。临床诊断为冠心病的
患者，冠脉CT正常22.5%，而冠脉CT异常77.5，差异显著（P<0.05）。总胆固醇、低密度脂蛋白、高密度脂蛋白、尿素、肌酐与冠脉
CT斑块明显相关，差异显著（P<0.05）。甘油三酯，尿素氮，尿蛋白，尿酸，空腹血糖，全血糖化血红蛋白，血红蛋白，血清肌钙蛋
白T，左室舒张末内径，左室射血分数等危险因素与冠脉斑块不相关（P>0.05）。Pearson相关显示，危险因素与斑块相关。ROC
曲线可见Framingham计分，肌酐，同型半胱氨酸和颈动脉内膜厚度预测冠脉斑块的准确性较高（P<0.05）。结论冠心病危险因
素与冠脉CT斑块明显相关，其中Framingham积分、肌酐、同型半胱氨酸和颈动脉内膜厚度相关最为密切，可以作为冠心病的一
般筛查。

Abstract: ObjectiveTo investigate the correlation between the findings by coronary computed tomography angiography
(CCTA) and the risk factors for major adverse cardiac events (MACE). MethodsThis cohort study involved706out-patients
who received examination with CCTA between June,2008and April,2011. The severity of coronary artery disease (CAD) was
graded to normal, mild, moderate, severe, and revascularization. Pearson correlation analysis and ANOVA were used to
evaluate the relationship between the risk factors for CAD and coronary plaques identified by CCTA, and the predictive
accuracy was determined by the receiver-operating characteristic (ROC) curve.ResultsOf the706patients,58.63% were found
to have abnormal CCTA findings. A older age, hypertension, hyperlipidemia, diabetes mellitus, cerebral infarction, CAD, and
myocardial infarction were associated with an significantly increased incidence of coronary plaques (P<0.01). The Framingham
score, LDL, HCY, IMT, HDL and TC were also significantly correlated with the severity of the coronary plaques (P<0.05). The
ROC curves showed that Framingham risk score (0.845), Cr (0.766), HCY (0.697), IMT (0.693) and HDL (0.316) had greater
predictive value for the occurrence of coronary plaques (P<0.001).ConclusionThe Framingham risk score, Cr, HCY, IMT and
HDL are validated by CCTA as the major coronary risk factors and can be used for screening of CAD.