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目的 比较急性与慢性冠状动脉综合征患者电子束CT(EBCT)冠状动脉钙化(CAC)的不同模式。方法264例患者(包括67例SAP、94例UAP和103例AMI)行选择性冠状动脉造影以检测粥样硬化狭窄的程度,行EBCT检查以计算CAC积分,分析各组患者CAC积分的差异及其与狭窄程度的关系。结果 ①SAP组CAC检测阳性率为100％,显著高于UAP组的87.23％和AMI组的86.41％(P<0.05)。②SAP组严重钙化的病人和动脉比例者显著高于UAP组和AMI组(P<0.05),钙化积分自然对数转换值(In[CS+1])的均数SAP组显著高于UAP组和AMI组(P<0.001)。③不同CAC程度在不同狭窄冠状动脉上的分布在SAP组与UAP组有明显差异。④AMI组梗死相关动脉多数无钙化或仅有轻度钙化,钙化积分显著低于非梗死相关动脉。结论 应用电子束CT研究显示,急性与慢性冠状动脉综合征患者存在不同的冠状动脉钙化模式,此点有助于理解这两类冠心病之间在临床和病理方面的差异。
Objective To compare the different patterns of coronary artery calcification (CAC) in patients with acute and chronic coronary syndromes by electron beam computed tomography (EBCT). Methods 264 patients (including 67 cases of SAP, 94 cases of UAP and 103 cases of AMI) underwent selective coronary angiography to detect the degree of atherosclerosis. The EBCT was performed to calculate the CAC score. The differences of CAC scores between the two groups were analyzed. Its relationship with the degree of stenosis. Results ① The positive rate of CAC in SAP group was 100%, which was significantly higher than 87.23% in UAP group and 86.41% in AMI group (P <0.05). (2) The mean calcification scores of patients and arteries in the SAP group were significantly higher than those in the UAP group and the AMI group (P <0.05), and the mean logarithm conversion value (In [CS + 1]) of the SAP group was significantly higher than that in the UAP group and the SAP group AMI group (P <0.001). ③ The distribution of different CAC levels in different stenosis coronary arteries was significantly different between SAP group and UAP group. ④ The majority of infarct-related arteries in AMI group had no or only mild calcification, and the calcification score was significantly lower than those in non-infarcted arteries. Conclusions Electron beam computed tomography (CT) studies have shown that there are different patterns of coronary artery calcification in patients with acute and chronic coronary syndromes, which may help to understand the clinical and pathological differences between these two types of coronary heart disease.