论文部分内容阅读
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。
Objective: To explore the relationship between hypertension and coronary atherosclerotic plaques using dual-source CT angiography (DSCTCA). Methods: The patients with coronary artery DSCTA were collected from April 2014 to August 2015 in our hospital. The patients were divided into hypertensive group (n = 150) and non-hypertensive group (n = 150) The pressure difference was divided into two groups: group 1, high pulse group pp ≥ 60 mm Hg (n = 90); group 2, low pulse group pp <60 mm Hg (n = 60), a total of 150 cases. The occurrence, distribution, degree of stenosis and plaque type in the two groups were observed and their correlations were analyzed. Results: The incidence of three or more coronary lesions in hypertension group was 61.7%, in non-hypertension group was 45.3%, in hypertension group the total number of coronary plaque was 28%, in non-hypertension group was 19.2% There was significant difference (P <0.05)). There was no significant difference in the composition of stenosis between hypertensive group and non-hypertensive group. The rates of severe stenosis and complete occlusion in hypertensive pulse pressure group were 8.6% and 3.7%, respectively, and those in low pulse pressure group were 4.4% and 0.8%, respectively. There was significant difference between the two groups (P <0.05). The incidence of mixed plaque in hypertension group was 54.5%, in non-hypertension group was 43.0%. The incidence of non-calcified plaque was 40.6% in hypertension group and 50.7% in non-hypertension group. There were significant differences between the two groups The incidence of mixed plaque was 57.5% in hypertension group and 49.1% in low-pulse-pressure group, and the difference was statistically significant between the two groups. Conclusion: The coronary DSCTA can accurately evaluate the relationship between hypertension and coronary artery disease. The number of coronary lesions in patients with hypertension, the number of three or more lesions, the total number of plaques was significantly higher than non-hypertensive patients, mixed plaque incidence higher. In the high pulse group, the severity of coronary artery stenosis was worse in the lower pulse pressure group.