肺癌低剂量CT筛查者冠状动脉钙化检出率及危险因素分析
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(中山大学附属第五医院放射科,广东省珠海市 519000)

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毛礼厅,硕士研究生,研究方向为胸腹部影像诊断,E-mail为1187121014@qq.com。

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广东省科技厅项目(2009B030801120)


Detection rate of coronary artery calcification and its risk factors analysis in low-dose CT screening population for lung cancer
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Department of Radiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, Guangdong 519000, China)

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    摘要:

    目的 探讨肺癌低剂量CT筛查人群中冠状动脉钙化检出率及相关危险因素。 方法 选取2013至2016年首次在我院行肺癌低剂量CT筛查的40岁以上无症状男性2722例,年龄40~81岁,其中吸烟者1052例,非吸烟者1670例。收集相关病史及血液生化检查资料,包括年龄、体质指数、吸烟史、糖尿病史及血糖、总胆固醇、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血尿酸、血肌酐。采用视觉评分方法进行冠状动脉钙化评分。对不同人群钙化检出率差异进行χ2检验;冠状动脉钙化与危险因素的分析采用Spearman相关分析及多因素Logistic回归。 结果 2722例中,发生冠状动脉钙化者642例(23.6%),其中轻、中、重度钙化分别占88.8%、8.9%、2.3%,平均年龄为56.7±9.8岁;无冠状动脉钙化者2080例,平均年龄为49.5±7.1岁。吸烟组冠状动脉钙化检出率高于非吸烟组(25.9%比22.2%,P=0.027)。冠状动脉钙化与年龄、吸烟、高血脂、糖尿病、血肌酐升高呈显著相关,与高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、血尿酸升高无显著关联。随着年龄增长,钙化检出率逐渐增加;50岁以下者,吸烟组的钙化检出率是非吸烟组的2倍多。 结论 无症状肺癌低剂量CT筛查人群中,轻度冠状动脉钙化检出率较高;年龄、吸烟、高血脂、糖尿病、血肌酐升高是冠状动脉钙化的危险因素。

    Abstract:

    Aim To investigate the prevalence and risk factors of coronary artery calcification in low-dose CT screening population for lung cancer. Methods A total of 2722 asymptomatic men over 40 years of age was selected, who were screened first time for lung cancer with low-dose CT from 2013 to 2016, aged 40-81 years old, including 1052 smokers and 1670 non-smokers. The related medical history and blood biochemical examination data were collected, including age, body mass index, smoking history, diabetes history and blood glucose, total cholesterol, triglyceride, low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (HDLC), serum uric acid and creatinine. Visual scoring method was used to assess coronary artery calcification score. The difference of calcification detection rate among different populations was examined by χ2 test. Coronary artery calcification and risk factors were analyzed by Spearman correlation analysis and multivariate Logistic regression. Results Among the 2722 cases, coronary artery calcification occurred in 642 cases (23.6%), of which mild, moderate and severe calcification accounted for 88.8%, 8.9% and 2.3%, respectively, with an average age of 56.7±9.8 years; There were 2080 cases without coronary artery calcification, with an average age of 49.5±7.1 years. The detection rate of coronary artery calcification in smoking group was higher than that in non-smoking group (25.9% vs 22.2%, P=0.027). Coronary artery calcification was significantly related to age, smoking, hyperlipidemia, diabetes mellitus, and high serum creatinine, but was not significantly related to HDLC, LDLC, and high serum uric acid. With the increase of age, the detection rate of calcification increased gradually. The detection rate of calcification in smoking group was 2 times higher than that in non-smoking group under 50 years old. Conclusion The detection rate of mild coronary artery calcification is higher in low-dose CT screening asymptomatic population for lung cancer. Age, smoking, hyperlipidemia, diabetes and high serum creatinine are risk factors for coronary artery calcification.

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毛礼厅,梁明柱,程玲,高洁冰,丁香莲,秦培鑫,柳学国.肺癌低剂量CT筛查者冠状动脉钙化检出率及危险因素分析[J].中国动脉硬化杂志,2017,25(8):807~811.

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  • 收稿日期:2016-11-18
  • 最后修改日期:2017-02-28
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  • 在线发布日期: 2017-07-12