胸部CT冠状动脉钙化积分与STEMI患者急诊PCI围术期并发症的相关性研究
Study on the correlation between CAC scores based on chest CT and perioperative complications of emergency PCI in STEMI patients
龚强 1傅向华 2汪雁博 2耿巍 1许巧玲 1付阳2
作者信息
- 1. 保定市第一中心医院心内科 保定 071000
- 2. 河北医科大学第二医院心内科 石家庄 050000
- 折叠
摘要
目的:探讨胸部CT冠状动脉钙化积分(CAC)与急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)围术期并发症的相关性.方法:选取2020年3月至2021年7月保定市第一中心医院心内科收治的263例STEMI患者,均行胸部CT检查和PCI手术,评估CAC积分,并根据CAC积分将患者分成无钙化和轻度钙化组(0～2分,129例)、中度钙化组(3～5分,88例)及重度钙化组(6～9分,46例),分析不同程度钙化组患者围术期并发症及随访期主要心血管事件(MACE)发生情况,比较各组差异并分析其与急诊PCI围术期并发症的相关性.结果:与无钙化和轻度钙化组相比,中度和重度钙化组患者年龄更大,差异有统计学意义(x2=45.815,P＜0.05),高血压、脑梗死、糖尿病、多支病变和MACE的发病率更高,差异有统计学意义(x2=6.762、11.071、6.064、25.036、21.694,P＜0.05).3组患者eGFR及NT-ProBNP水平比较,差异有统计学意义(F=8.592,Z=20.890,P＜0.05).与重度钙化组相比,无钙化和轻度钙化组冠状动脉血栓发生率较高(x2=7.748,P＜0.05).根据logistic回归分析,冠状动脉血栓、中度钙化及重度钙化患者是出现轻微并发症的危险因素(OR=4.847、5.280、11.135,P＜0.001);年龄越大、患有高血压或冠状动脉重度钙化患者更容易出现严重并发症,术后1年内MACE发生率更高,是围术期并发症的危险因素(OR=1.151、7.982、10.555、21.729,P＜0.05).结论:胸部CT的CAC积分评估出的中度及重度钙化病变患者的围术期并发症发生率更高,基于胸部CT的CAC积分可用于评估急诊PCI围术期的并发症及术后1年内MACE.
Abstract
Objective:To investigate the correlation between coronary artery calcification(CAC)scores based on computed tomography(CT)on chest and perioperative complications of emergency percutaneous coronary intervention(PCI)of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods:A total of 263 STEMI patients who admitted to the Chest Pain Center of the Department of Cardiovascular Medicine of Baoding NO.1 Central Hospital from March 2020 to July 2021 were selected.All of them underwent CT examination on chest,and were assessed by CAC scores.They were divided into no calcification and mild group(0～2 scores,129 cases),moderate calcification group(3～5 scores,88 cases)and severe calcification group(6-9 scores,46 cases)according to CAC scores.Perioperative complications and major cardiovascular events(MACE)of patients with different degrees of calcification in the follow-up period were analyzed.The differences among different groups were compared.The correlation between CAC scores and perioperative complications of emergency PCI was further analyzed.Results:Compared with patients of no calcification and mild group,the ages of patients of moderate and severe calcification groups were older(x2=45.815,P＜0.05),and the incidences of hypertension,cerebral infarction,diabetes,multi-vessel disease and MACE of moderate and severe calcification groups were significantly higher(x2=6.762,11.071,6.064,25.036,21.694,P＜0.05).There were significant differences in eGFR and NT-ProBNP levels among the 3 groups(F=8.592,Z=20.890,P＜0.05).Compared with the severe calcification group,the incidence of coronary thrombosis was higher in the no calcification and mild group(x2=7.748,P＜0.05).According to logistic regression analysis,the patients with coronary thrombosis,moderate and severe calcification were more likely to have minor complications(OR=4.847,5.280,11.135,P＜0.001).Patients with older age,hypertension or severe calcification of coronary artery were more likely to occur serious complications,and the MACE incidence was higher within 1 year after surgery(OR=1.151,7.982,10.555,21.729,P＜0.05).Conclusion:Patients with moderate and severe calcification lesions who are assessed by CAC scores based on chest CT have a higher incidence of perioperative complications.CAC scores based on chest CT can be used to assess perioperative complications of emergency PCI and MACE within 1 year after surgery.
关键词
冠状动脉钙化积分/胸部CT/围术期并发症/急性ST段抬高型心肌梗死Key words
Coronary artery calcification score/Computed tomography(CT)on chest/Perioperative complication/Acute ST-segment elevation myocardial infarction(STEMI)引用本文复制引用
基金项目
河北省财政厅 河北省卫生健康委2023年政府资助临床医学优秀人才培养项目(ZF2023152)
保定市科技计划项目(2241ZF065)
出版年
2024
国家科技期刊平台
NSTL
万方数据