首页|CT冠脉钙化积分与冠心病冠脉狭窄程度的关系及预测MACE的价值

CT冠脉钙化积分与冠心病冠脉狭窄程度的关系及预测MACE的价值

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目的 分析CT冠脉钙化积分与冠心病冠脉狭窄程度的关系及预测心血管不良事件(MACE)的价值.方法 选择2020年7月至2021年7月就诊于本院的108例冠心病患者作为研究对象,所有患者均接受冠脉CT血管成像(CTA)检查,计算CT冠脉钙化积分,分析CT冠脉钙化积分(TCS与Shemesh积分)与冠心病冠脉狭窄程度的关系.收集所有患者一般资料(性别、年龄、基础疾病、吸烟史等),根据是否合并MACE分为MACE组与无MACE组,经单因素及多因素Logistic回归分析MACE发生的危险因素;绘制ROC曲线,分析CT冠脉钙化积分预测MACE发生的价值.结果 根据冠脉造影检查结果将108例冠心病患者分为轻度狭窄组43例(39.81%)、中度狭窄组51例(47.22%)、重度狭窄组14例(12.96%);重度狭窄组的TCS评分、Shemesh积分最高,中度狭窄组其次,轻度狭窄组最低(P<0.05);经Kendall的tau-b(K)检验,TCS评分、Shemesh积分与冠脉狭窄程度呈正相关(r=0.751、0.674,P均<0.05);Pearson相关性发现,冠心病患者的TCS评分与Shemesh积分呈正相关(r=0637,P<0.05);MACE组与无MACE组的性别、年龄、BMI、病程、吸烟史、糖尿病、高血压及血脂异常对比,差异无统计学意义(P>0.05);MACE组NT-proBNP、TCS评分及Shemesh积分均高于无MACE组(P<0.05);经Logistic回归分析,结果显示,NT-proBNP、TCS评分及Shemesh积分是影响冠心病合并MACE发生的危险因素(OR>1,P<0.05);ROC曲线结果发现,TCS评分、Shemesh积分及联合预测冠心病合并 MACE 发生的 AUC 为 0.796(95%CI:0.694-0.899)、0.770(95%CI:0.648-0.891)、0.816(95%CI:0.722-0.909).结论 CT冠脉钙化积分与冠心病冠脉狭窄程度呈正相关,TCS评分、Shemesh积分是影响MACE发生的危险因素,且二者联合可提高预测冠心病合并MACE发生的价值.
Relationship between CT Coronary Calcification Score and Coronary Stenosis Degree of Coronary Heart Disease and Its Predictive Value of MACE
Objective To analyze the relationship between CT coronary calcification score and the degree of coronary stenosis in coronary heart disease and the value of predicting cardiovascular adverse events(MACE).Methods A total of 108 patients with coronary heart disease admitted to our hospital from July 2020 to July 2021 were selected as the study objects.All patients received coronary CT angiography(CTA)examination,computed CT coronary artery calcification scores,and analyzed the relationship between CT coronary artery calcification scores(TCS and Shemesh scores)and coronary artery stenosis degree.General data(gender,age,underlying diseases,smoking history,etc.)of all patients were collected and divided into MACE group and non-MACE group according to whether they were combined with MACE.The risk factors of MACE were analyzed by univariate and multivariate Logistic regression.ROC curve was drawn to analyze the value of CT coronary calcification score in predicting the occurrence of MACE.Results According to the results of coronary angiography,108 patients with CHD were divided into mild stenosis group 43 cases(39.81%),moderate stenosis group 51 cases(47.22%),and severe stenosis group 14 cases(12.96%).TCS score and Shemesh score were the highest in severe stenosis group,followed by moderate stenosis group,and the lowest in mild stenosis group(P<0.05).Kendall's tau-b(K)test showed that TCS score and Shemesh score were positively correlated with the degree of coronary artery stenosis(r=0.751,0.674,P<0.05).Pearson correlation showed that TCS score of CHD patients was positively correlated with Shemesh score(r=0637,P<0.05).There was no significant difference in gender,age,BMI,course of disease,smoking history,diabetes,hypertension and dyslipidemia between MACE group and non-MACE group(P>0.05).The scores of NT-proBNP,TCS and Shemesh in MACE group were higher than those in non-MACE group(P<0.05).Logistic regression analysis showed that NT-proBNP,TCS score and Shemesh score were the risk factors for coronary heart disease combined with MACE(OR>1,P<0.05).ROC curve results show that,The AUC of TCS score,Shemesh score and combined prediction of coronary heart disease with MACE were 0.796(95%CI:0.694-0.899),0.770(95%CI:0.648-0.891),0.816(95%CI:0.722-0.909).Conclusion CT coronary artery calcification score is positively correlated with the degree of coronary artery stenosis in CHD.TCS score and Shemesh score are risk factors affecting the occurrence of MACE,and their combination can improve the value of predicting the occurrence of CHD with MACE.

Coronary Heart DiseaseDegree of Coronary Artery StenosisCT Coronary Artery Calcification ScoreCardiovascular Adverse EventsPredictive Value

徐雪颖、巫迎春、赵志维、邵元伟、史斌

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江苏大学附属医院影像科(江苏镇江 212000)

冠心病 冠脉狭窄程度 CT冠脉钙化积分 心血管不良事件 预测价值

江苏省卫生健康委医学科研课题

ZD20210022

2024

中国CT和MRI杂志
北京大学深圳临床医学院 北京大学第一医院

中国CT和MRI杂志

CSTPCD
影响因子:1.578
ISSN:1672-5131
年,卷(期):2024.22(10)