摘要:
目的:利用双源CT血管成像技术(DSCTCA)探讨高血压与冠脉粥样硬化斑块两者的关系。方法:收集我院2014年4月至2015年8月检查冠状动脉DSCTA患者的病例,分为高血压组(n=150)和非高血压组(n=150),其中高血压组又根据脉压差分为两组:1组,高脉压组pp≥60 mm Hg(n=90);2组,低脉压组pp<60 mm Hg(n=60)共150例。观察两组冠脉病变的发生、分布、狭窄程度及斑块类型,分析其相关性。结果:高血压组发生3支及以上冠脉病变的概率为61.7%,非高血压组为45.3%,高血压组冠脉斑块总数比率为28%,非高血压组为19.2%,两组比较有显著差异(P<0.05))。高血压组与非高血压组狭窄程度的构成无显著差异。高血压高脉压组重度狭窄、完全闭塞的比例分别为8.6%、3.7%,低脉压组分别为4.4%、0.8%,两组之间差异有统计学意义(P<0.05)。高血压组混合斑块的发生率为54.5%,非高血压组为43.0%,非钙化斑块的发生率,高血压组为40.6%,非高血压组为50.7%,两组比较差异均有统计学意义;高血压高脉压组混合斑块的发生率为57.5%,低脉压组为49.1%,两组比较差异亦有统计学意义。结论:冠脉DSCTA可以较准确评估高血压与冠脉病变之间的关系。高血压患者的冠脉病变人数,三支及以上病变支数、斑块总数较非高血压者明显增高,混合斑块发生率更高。高脉压组较低脉压组冠脉狭窄程度更加严重。
Abstract:
Objective: To investigate the correlation between hypertension and the formation of coronary atherosclerotic plaque by DSCTA. Methods: Collect patients who underwent coronary DSCTA from April 2014 to August 2015 and divided into hypertension group(n= 150) and non-hypertension group(n= 150) on the basis of cases. The hypertension group was divided into high pulse pressure(PP > 60 mm Hg) and low pulse pressure(PP < 60 mm Hg) group. The incidence rate of plaque, distribution characteristics and types were observed. Results: The incidence rate of 3 and above coronary artery vascular lesions was 61.7% in hypertension group and 45.3% in non hypertension group. The incidence rate of plaque was 28% in hypertension group and 19.2% in non hypertension group, the difference between the two groups were statistically significant(P < 0.05). The degrees of coronary artery stenosis between hypertension and non hypertension groups have no significant differences, but Severe stenosis was 8.6% and occlusion was 3.7% in high pulse pressure group; and were 4.4% and 0.8% respectively in low pulse pressure group, the difference were statistically significant(P < 0.05). Occurrence rate of mixed plaque was 54.5% in hypertension group and 43.0% in non hypertension group. The incidence of non calcified plaque was 40.6% in hypertension group, 50.7% in non hypertension group, the difference were statistically significant(P < 0.05). Occurrence rate of mixed plaque was 57.5% in group 1 and 49.1% in group 2,the difference between the two groups were statistically significant(P < 0.05). Conclusion: DSCTCA can evaluate the relationship between the hypertension and coronary artery plaque. The range of coronary involved by plaque is wider, incidence rate of mixed plaque is higher and having more risk prone to cardiovascular events in hypertension, and will be more serious with higher pulse pressure.
百度学术
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