摘要
目的探讨左冠状动脉主干(LM)的X线解剖特征与前降支(LAD)及回旋支(LCX)近段狭窄发生率的关系。方法搜集2020年8月至2021年3月行冠状动脉造影的患者400例,分别测量其LM的直径、长度、分叉角度、LAD及LCX近段病变的狭窄程度,根据狭窄程度≥50%和<50%将所有患者分别分为LAD、LCX、LM分支显著狭窄组和非显著狭窄组,并引入性别、年龄、高血压、糖尿病、高血脂、吸烟史等临床指标。分析LM分支近段显著狭窄与各临床指标的关系及显著狭窄的独立危险因素。结果所有患者中,LM直径(4.28±1.04)mm,LM长度(11.90±5.52)mm,LM分叉角度(73.20±37.83)°,男性患者LM分叉角度明显大于女性,其差异有统计学意义(P<0.05);LM分支近段狭窄发生率男性(175/240,72.92%)高于女性(100/160,62.50%),其差异有统计学意义(P<0.05);LAD、LCX及LM分支近段有显著狭窄与无显著狭窄患者年龄及LM直径相比较差异均有统计学意义(P<0.05);Logistic回归分析显示除传统的因素外,LM直径较小为其分支近段有显著狭窄的独立危险因素,其最佳界值为4.655 mm,直径<4.655 mm者分支近段发生狭窄的风险是直径≥4.655 mm者的2.123倍;LM长度较大为其分支近段显著狭窄的独立危险因素,其最佳界值为12.035 mm,长度≥12.035 mm者分支近段发生狭窄的风险是长度<12.035 mm者的1.771倍。结论除传统因素外,LM直径较小和长度较大为其分支血管近段狭窄发生的独立危险因素,且直径<4.655 mm或长度≥12.035 mm者分支血管近段狭窄发生的风险高于其他患者;而分叉角度对分支血管近段狭窄的影响较小。
Objective To investigate the relationship between X-ray anatomical feature of left main coronary artery(LM)and the incidence of stenosis in the proximal segment of left anterior descending coronary artery(LAD)and left circumflex coronary artery(LCX).Methods From August 2020 to March 2021,400 patients underwent coronary angiography were collected.The diameter and the length of LM,the bifurcation angle of LAD and LCX,the proximal segment stenosis of LAD and LCX were measured.All patients were divided into LAD(LCX or LM branch)significant stenosis group and non significant stenosis group according to the stenosis≥50%or<50%.The clinical indicators such as gender and age,hypertension,diabetes,hyperlipidemia,smoking history were also included.The relationship between the degree of stenosis in proximal LM branches and the clinical indicators,as well as the independent risk factors of significant stenosis were analyzed.Results In all patients,the diameter of LM was(4.28±1.04)mm,the length of LM was(11.90±5.52)mm,the bifurcation angle of LM was(73.20±37.83)°,The angle of LM bifurcation in male patients was higher than that of women,and the difference between them was significant(P<0.05);The incidence of significant stenosis of proximal LM branches in men(175/240,72.92%)was higher than that in women(100/160,62.5%)(P<0.05);There were significant differences in age and LM diameter between patients with significant stenosis of LAD,LCX and proximal LM branches and those without significant stenosis(P<0.05);Logistic regression analysis showed that the smaller diameter of LM and longer length of LM were independent risk factors for significant stenosis in the proximal segment of its branches in addition to the traditional risk factors.The critical value of LM diameter was 4.655 mm.The risk of stenosis in the proximal segment of LM with diameter<4.655 mm was 2.123 times higher than patients with diameter≥4.655 mm;The critical value of LM length was 12.035 mm.The risk of proximal branch stenosis in patients with length≥1
作者
于曰俊
王信
张超
裴美艳
邵静波
YU Yuejun;WANG Xin;ZHANG Chao(Weifang People’s Hospital,Weifang,Shandong Province 261041,P.R.China)
出处
《临床放射学杂志》
北大核心
2022年第6期1043-1048,共6页
Journal of Clinical Radiology
基金
潍坊市卫健委科研项目计划(编号:WFWSJK-2020-254)。
关键词
左冠状动脉主干
X线解剖
前降支
回旋支
冠状动脉狭窄
Left main coronary artery
X-ray anatomy
Left anterior descending coronary artery
Left circumflex coronary artery
Coronary artery stenosis
