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目的探讨高龄患者冠状动脉钙化情况及影响因素。方法回顾性分析该院247例80岁及以上高龄患者的临床资料,采用双源多层螺旋CT(Dual-source spiral computed tomography,DSCT)进行冠状动脉造影,计算钙化积分(Calcification score,CS)。结果无冠脉钙化(CS 0分)9例(3.94%),1分≤CS≤10分3例(1.32%),11分≤CS≤100分10例(4.39%),101分≤CS≤400分34例(14.91%),CS>400分为172例(75.44%)。与CS≤400组相比,CS>400组中,男性所占比例更大,病变血管支数较多,糖尿病所占比例更高,空腹血糖、低密度脂蛋白C(low density lipoprotein C,LDL-C)、血磷、超敏C反应蛋白(hypersensitivity c-reactive protein,hs-CRP)、血清胱抑素C及血尿酸浓度更高,高密度脂蛋白C(high density lipoprotein C,HDL-C)浓度更低,二组差异有统计学意义(P均<0.05)。结论高龄患者冠状动脉钙化发生率较高,钙化程度更严重;男性、病变血管支数多、糖尿病所占比例更高、空腹血糖增高、血清LDL-C增高、高血磷、高hs-CRP、高血清胱抑素C、高血尿酸浓度及HDL-C浓度降低均为高龄患者冠状动脉钙化的影响因素。
Objective To investigate coronary artery calcification and its influencing factors in elderly patients. Methods The clinical data of 247 elderly patients aged 80 years and older were retrospectively analyzed. Coronary angiography was performed by dual-source spiral computed tomography (DSCT) to calculate the Calcification score (CS). Results There were 9 cases (3.94%) without coronary artery calcification (CS 0), 3 cases (1.32%) with 1 point ≤CS≤10, 10 cases (4.39%) with 11 points ≤CS≤100, 101 points≤CS≤ 400 cases were 34 cases (14.91%), CS> 400 cases were 172 cases (75.44%). Compared with CS≤400 group, CS> 400 group had a greater proportion of men, more vascular lesion, higher proportion of diabetes, fasting blood glucose, low density lipoprotein C (LDL) C, serum phosphorus, hs-CRP, serum cystatin C and serum uric acid were higher, high density lipoprotein C (HDL-C) ) Lower concentration, the difference between the two groups was statistically significant (P all <0.05). Conclusion The incidence of coronary artery calcification in elderly patients is higher and the degree of calcification is more serious. In men, the number of vascular vessels is more, the proportion of diabetes is higher, the fasting blood glucose is higher, the serum LDL-C is higher, hyperphosphatemia, hs-CRP, Serum levels of cystatin C, hyperuricemia, and HDL-C concentrations were all associated with coronary artery calcification in elderly patients.