| 冠状动脉桥血管病变的CT评价和危险因素分析 |
| 投稿时间：2010-08-23 点此下载全文 |
| 引用本文：徐东,任杰,张科峰,刘飞,李洪利,刘燕晖.冠状动脉桥血管病变的CT评价和危险因素分析[J].医学研究杂志,2010,39(12):99-103 |
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| 中文摘要:目的探讨64层螺旋CT在冠状动脉桥血管评价中的应用价值，并分析导致桥血管病变的危险因素。方法2005年5月~2008年1月通过64层螺旋CT共随访到35例冠脉搭桥术后患者并记录一般资料。35位患者共89支桥血管，动脉桥21支，静脉桥68支。根据CABG术后是否复发心绞痛分组，对两组间桥血管的通畅率作χ2检验。将患者按照桥血管通畅与否分为两组，首先进行单因素分析，按P<0.05标准筛选出的变量纳入Logistic多因素回归分析，逐步剔除混杂因素得出导致桥血管病变的危险因素。结果近端吻合口、桥血管本身、远端吻合口和远端靶向引流血管的可评价率分别为98.5%（65/66）、989%（88/89）、93.3%（83/89）、92.1%（82/89）。动脉桥血管的可评价率为85.7%（18/21），静脉桥血管的可评价率为91.2%（62/68），两两比较差异无统计学意义（P=0.755＞0.05）。桥血管的总体可评价率为89.9%（80/89）。有心绞痛复发组桥血管的通畅率为66.7%（16/24），无心绞痛复发组桥血管的通畅率为88.7%（47/53），组间比较差异有统计学意义。Logistic回归分析结果得出LDL-C，Glu相关性明显；其他变量无统计学意义。结论64层MSCTA对冠状动脉桥血管的评价可以很好地满足诊断需要。冠状动脉桥血管病变是CABG术后心绞痛复发的重要原因。Glu, LDL-C是CABG术后冠状动脉桥血管病变的独立危险因素。 |
| 中文关键词:多层螺旋计算机体层摄影 冠状动脉搭桥术 多因素危险因子 |
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| Evaluation of Coronary Artery Bypass Grafts Lesion with 64-slice Multi-slice Spiral Computed Tomography and Risk Factor Analysis |
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| Abstract:ObjectiveTo evaluate the application value of 64-slice multi-slice spiral computed tomography (MSCT) in detecting coronary artery bypass grafts lesion and analyze the risk factors of coronary artery bypass grafts lesion basing on the findings of 64-slice MSCT. Methods89 grafts of 35 cases were detected by MSCTA, including 21 arterial grafts and 68 venous grafts from May 2005 to January 2008. The patients were divided into two groups according to recurrence of angina or not, and patency of coronary artery bypass grafts was compared using chi-square test. The patients were divided into other two groups according to patency of coronary artery bypass grafts, and univariate analysis was made firstly, then the variates having statistical significance (P<0.05) were accepted in to logistic regression analysis. Confounding factors were rejected stepwise, and the risk factors leading to coronary artery bypass grafts lesion were found. ResultsEvaluability of proximal anastomoses, bypass grafts, distal anastomoses, and distal runoff arteries were 98.5% (65/66), 989%（88/89）, 93.3% (83/89), and 92.1% (82/89), respectively. Evaluability of arterial grafts, venous grafts were 85.7% (18/21), 91.2% (62/68), respectively, and they had no statistical significance (P=0.755>0.05). Total evaluability of bypass grafts was 899% (80/89). The grafts patency rate of patients who recurred angina or not was 66.7% (16/24) or 88.7% (47/53), and there was statistical significance between them (P=0.045<0.05). Logistic regression analysis results were the following:for LDL-C,β=1.491,P=0.043,OR=4.443;for Glu,β=1.744, P=0.014, OR=5.720; other variables had no statistical significance. Conclusion64-slice MSCTA can satisfy the diagnostic requirement to evaluate the coronary artery bypass grafts. Coronary artery bypass grafts lesion is an important factor of postoperative angina recurrence. Serum glucose, low density lipoprotein-cholesterol are independent risk factors of postoperative coronary artery bypass grafts lesion. |
| keywords:Multi-slice spiral, computed tomography Coronary artery bypass grafting Multiple risk factors |
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