新疆维吾尔族与汉族冠状动脉64层多层螺旋CT血管造影的特征及其比较
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的:分析冠状动脉64层螺旋CT血管造影(CTA)的影像学表现,评价维吾尔族冠状动脉的形态学特征,并比较维吾尔族与汉族冠状动脉形态学的差异。方法:回顾性分析88例维吾尔族样本及与其匹配的88例汉族样本的64层螺旋CT冠状动脉CTA成像资料,并将两者的结果进行统计学分析比较。结果: 1.所收集88例维吾尔族冠状动脉CTA样本中,以右优势最多(64.77%);左冠状动脉开口以中1/3、窦内最多(73.86%,70.45%);右冠状动脉开口以右1/3、窦内最多(57.95%,64.80%);前、后降支,左回旋支,右冠状动脉的终止点分别以后纵沟下1/3(42.05%)、后纵沟中1/3(51.16%)、心左缘(59.09%)、左室后面(63.64%)最多;心肌桥发生位置以前降支(41.94%)最多。2.维吾尔族与汉族样本在以下方面的差别具有统计学意义:左冠开口位置纵向划分(T= 8319,P = 0.0331)、右冠开口位置纵向划分(T= 6936,P = 0.0331)、钝缘支个数(T= 7143,P=0.0214)、锐缘支发生率(x2=5.8381,P = 0.0157)、冠状动脉畸形发生率(x2= 5.1948,P = 0.0227)、冠状动脉畸形发生侧别(T=100,P=0.0213)、冠状动脉各种畸形所占比例(T= 106.5,P=0.0039)、冠状动脉各种变异所占比例(T= 6886.5,P=0.0242)、左冠各种变异所占比例(T= 2692,P=0.0008)、右冠各种变异所占比例(T= 968.5,P= 0.0153)。结论:64层螺旋CT冠状动脉CTA检查为冠状动脉形态学研究提供了一种实用的方法,借助于该方法,我们研究发现,维吾尔族冠状动脉形态具有其独特性,与汉族冠状动脉形态学特征相比,存在多项差异,这些差异一方面可能使两民族在冠状动脉造影术检查时的表现有所不同,从而提醒临床医师在行冠脉造影术操作时注意名族冠脉特点,以更好地进行操作;另一方面,可能和两民族的冠心病发病率及特点不同有一定程度的关联。
Objective: To analysis the morphological findings of Coronary Angiography on 64 slice multiple CT (MSCT) and study the difference of coronary artery’s morphological characteristics between Uyghur and Han population in Xing Jiang. Methods: A study was made for 88 Uyghur samples and matched Han samples retrospectively, all the coronary images dates obtained by MSCTA were evaluated by 2 doctors respectively. Then the statistical comparison were made for this two groups. Results: 1.In the 88 Uygur coronary artery CTA dates“, right-dominant”is most regularly(64.77%); most of the left coronary artery originate from the middle 1/3 of the left aortic sinus(73.86%,70.45%),and most of the right coronary artery originate from the right 1/3 of the right aortic sinus(57.95%,64.80%); the most common ends of the Left Anterior Descending Branch(LAD), Posterior Descending Artery(PDA) ,Left Circumflex Artery(LCX),and the RightCoronary Artery(RCA) are the under 1/3 of the posterior interventricular groove(42.05%) , the middle 1/3 of the posterior interventricular groove(51.16%), the left side of the heart (59.09%)and the back of the left cardiac ventricle(63.64%); The highest incidence of the place of myocardial bridge is the anterior interventricular branch (41.94%).2. The coronary artery's morphological characteristics of Uyghur population and Han population are different in following : the originate of the Left Coronary Artery(LCA) in vertical (T= 8319,P = 0.0331),the originate of the Right Coronary Artery(RCA) in vertical (T= 6936,P = 0.0331),the number of Obtuse Marginal Branch(OM)(T= 7143,P=0.0214),the rate of the Sharp Marginal Branch's appearance(x2=5.8381,P = 0.0157),the proportion of coronary artery's malformations(x2= 5.1948,P = 0.0227),the side of occurrence of coronary artery's malformations(T=100,P=0.0213),the proportion of each kind of coronary artery's malformations(T= 106.5,P=0.0039),the proportion of each kind of coronary artery's variability(T= 6886.5,P=0.0242), the proportion of each kind of LCA's variability(T= 2692,P=0.0008)and the proportion of each kind of RCA's variability(T= 968.5,P= 0.0153).Conclusion: MSCT Coronary angiography provides a practical method for the study of the Minority’s coronary artery morphological characteristics.By this method ,we find that the coronary artery of Uygur exist a individuality and is different from the characteristics of Han.On the one hand ,these difference may relate to different pattens in Coronary angiography and clinicist should notice this ;On the other hand , these may relate to differences between Uygur and Han in the incidence and severity of CoronaryHeart Disease(CHD).
引文
[1] Woodward M, Huxley H, Lam TH, et al.A comparison of the associations between risk factors and cardiovascular disease in Asia and Australasia.[J]Eur J Cardiovasc Prev Rehabi,2005, 1(5): 484-491
    [2] Slater J, Selzer F, Dorbala S, et al. Ethnic differences in the presentation treatment strategy and outcomes of percutaneous coronary intervention.[J]Am J Cardio,2003, 92(7):773-778
    [3]艾尔肯.阿吉,张向阳,杨坤河,等.229例维吾尔族冠心病患者冠状动脉造影结果的对比分析[J].山西医科大学学报,2001,32(4):324-325
    [4]马依彤,刘宇,汤宝鹏,等.新疆维吾尔族与汉族冠状动脉造影对比分析[J].中国介入心脏病学杂志,2001,9(4):211-212
    [5]何秉贤,张建义.乌鲁木齐心血管病人监测1985年小结[C].第二届西北几省心血管会议汇编,1986:1-10
    [6]马依彤,刘宇,汤宝鹏,等.新疆维吾尔族与汉族冠状动脉造影对比分析[J].中国介入心脏病学杂志,2001;9(4):211-212
    [7]姚娟,程祖亨.维吾尔族和汉族冠心病患者冠状动脉病变支数与危险因素的对照分析.新疆医科大学学报.2005,12
    [8] Guglielmo LDi, Guttadauro M.A roentgenologic study of the coronary arteries in the Living[J].Acta Radiol, Suppl,1952,97:1-82
    [9] Whitten MB.A review of the technical methods of demonstrating the circulation of the heart.Arch Int Med, 1928, 42:846-864
    [10] Jonsson G.Visualization of the coronary arteries. Acta Radiol, 1948,29:536-540
    [11]张炳常,中国儿童心脏冠状动脉类型的观察[J].解剖学报,1957,2(4):327-346
    [12]孙廷魁,刘朝宝.国人冠状动脉的调查报告[J].解剖学报.1959.4(1-2):91-101
    [13] Gross L,Paul B. The blood supply to the heart. [J]Hoeber, 1921
    [14] Adachi B,Maruzen Co.Das Arteriensystem der Janpaner.Kyoto,1928:17-22
    [15]王衡,朱新安,王海涛,等.中国维吾尔族心脏面积及大血管基本数值侧量[J].新疆医学院学报,1987,10(1):1-6
    [16]李新春,孙绪荣,王衡.新疆锡伯族、汉族成人心脏体积X线测量研究[J].新疆医学院学报,1997,20(4):261-264
    [17] Nieman K, Creasing BJ,Van Geuns RJ, et al.Uesfulness of multislice computed tomography for detecting obstructive Coronary disease. [J]Am J Cardionl, 2002, 89:913-918
    [18] Kopp AF,Schroder S,Kuettner A,et al.Coronary arteries,retrospectively ECG-gated multi-detecter row CT angiography with selective optinization of the imagine reconst ruction window.[J]Radiology,2001,221:683-688
    [19]毛定飚,滑炎卿,张国真,等.多层螺旋CT评价冠状动脉内软斑块的准确性[J].中华放射学杂质,2006,40:722-725
    [20] Windecker S,Maier-Rudolph W,Bonzel T,et al.Interventional cardiology in Europe 1995. [J]Eur Heart,1999,20(7):484-495
    [21] Ropers D,Baum U, Pohle K,et al.Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. [J]Circulation,2003,107(5) :664-666
    [22] Cury RC,Ferencik M,Achenbach S,et al.Accuracy of 16-slice multi-detector CT to quantify the degree of coronary artery stenosis: assessment of cross-sectional and longitudinal vessel reconstructions. [J]Eur J Radiol,2006,57:345-350
    [23]柏树令.系统解剖学[M].北京,人民卫生出版社,2001.1:223-228
    [24]凌凤东,林奇,赵根然.心脏解剖与临床[M].北京,北京大学医学出版社,2005.1
    [25]李占全,冠状动脉造影与临床[M].沈阳,辽宁科学技术出版社,2000.
    [26] Yamanaka O:Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography.[J]Cathet Cardiovasc Diagn 1990,21(1): 28-40
    [27] Klues HG,Schwarz ER,Vom Dahj J,et al.Disturbed intracoronary hemodynamics in myocardial bridging early normalization by intracoronary stent placement. [J] Circulation ,1997 ,96 :2905-2913
    [28] Munakata K,Sato N,Sasaki Y, et al . Two cases of variant form angina pectoris associated with myocardial bridge. [J]Jpn Circ J,992,56 :1248-1252
    [29] Kodama K, Morioka N, Hara Y, et al.Coronary vasospasm at the site of myocardial bridge-report of two cases. [J]Angiology ,1998 ,49 :659- 663
    [30] Grover M, Mancono GB. Myocardial bridge associated with pacing-induced coronary spasm. [J] Am Heart J , 1984 ,108 :1540-1543
    [31] Ishii T, A suwa N, Masuda S, et al.The effects of a myocardial bridge on coronary atherosclerosis and ischaemia. [J]J Pathol ,1998 ,185:4-9
    [32]鲜军舫,田其昌,王振常,等.鼻和副鼻窦解剖变异的CT研究[J].中华放射学杂志,1998,32 (1):53-54
    [33]温沁竹,崔炜,孙宝贵,等.冠状静脉窦及其属支的X线解剖研究[J].中华心律失常学杂志,1999,3 (3):188-190
    [34]吴任国,王振常,鲜军舫,等.视交叉的MRI解剖[J].中华放射学杂志2004, 38 (2),165-169
    [35]孙绪荣,白德波,王志勤,等.哈萨克族和汉族青年心脏体积X线测量研[J].新疆医科大学学报,2001,24(1):58-59
    [36]张凤兰,杨广忠,乌鲁木齐地区维吾尔族、汉族头颅X线测量[J].新疆医科大学学报,1995,18(3):141-143
    [37] Aydinlar A,Cicek D,Senturk T, etal. Primary congenital Anomalies of the coronary arteries:a coronary arteriographic study in Western Turkey. [J]IntHeartJ,2005,46:97-103
    [38] Topaz O,DeMarchena R,Perin E,et al.Anomalous coronary arteries : angiographic findings in 80 patients. [J]Int J Cardiol 1992,34:129-138
    [39] Kaku B, Shimizu M, Yoshio H, et al.Clinical features of prognosis of japanese Patients with anomalous origin of the coronary artery.[J]Jpn Circ J,1996,60(10):731-741
    [40] Kardos A, Babai L, Rudas L,et al.Epidemiology of congenital coronary artery anomalies: a coronary arteriography study on a central European population. [J]Cathet Cardiovasc Diang, 1997,42(3):270-275
    [41] Garg N,Tewari S, Kapoor A,Primary congenital anomalies of the coronary arteries: a coronary arteriographic study. [J]Int J Cardiol,2000,Jun 12;74(1):39-46.
    [42]姚民,陈钰,吴元,等.成年人冠状动脉造影先天性变异分析[J].中国循环杂志,1999,14(3):132-134
    [43]王鹤远,齐国先.冠状动脉先天性变异的冠状动脉造影分析[J].中国医科大学学报,2006,35(1):96-97
    [44]贾文霄,张其镍,孙绪荣,等.新疆维吾尔族与汉族冠状动脉造影对比分析[J].中华放射学杂志,1994,28(12),836-838
    [45] Datta J, White CS, Anomalous coronary arteries in adults: depiction at multi-detector row CT angiography.[J]Radiology, 2005 ,235(3):812-818
    [46] Rainer S, Steffen F,Juergen B ,et al.Congenital Anomalies of the Coronary Arteries:Imaging with Contrast enhanced , Multidetector Computed Tomography[J ]. Eur Radiol ,2005 ,15 6 :1110-1221
    [47] Heshui S,Andrik JA , Hans-Juergen B ,et al.Multislice CT imaging of anomalous coronary arteries. [J]. Eur Radiol ,2004 ,14 (12) :2172-2181
    [48] Romano S, Morra A, Del Borrello M,et al. Multi-slice computed tomography and the detection of anomalies of coronary arteries. [J]J Cardiovasc Med (Hagerstown). 2008 ,9(2):187-94
    [49]王照谦,杨志强,朱皓,等.多层螺旋CT诊断冠状动脉起源异常的价值[J].中华医学杂志,2005,40:80-82
    [50] Serota H,Barth CW,Seuc C,et al.Rapid identification of the course of anomalous coronary arteries in adults:The "dot and eye" method.[J]Am J Cardiol,1990,65(13): 891-898
    [51]章士正,胡秀华.冠状动脉畸形的16层CT诊断[J].中国医学计算机成像杂志2,2005,11(5):325-328
    [52] Sato Y, Inoue F, Matsumoto N, et al. Detection of anomalous origins of the coronary artery by means of multislice computed tomography. [J]Circ J. 2005 ,69(3):320-324
    [53] Budoff MJ,Ahmed V,et al.Coronary anomalies by cardiac computed tomographic angiography.[J]Clinical Cardiology Volume 29(11): 489-493.
    [54]戴沁怡,吕飘,张兆琪.64层螺旋CT诊断成人冠状动脉起源异常[J].中华放射学杂志.2006.40(8):804-807
    [55] Shi H, Aschoff AJ, Brambs HJ,et al.Multislice CT imagi ng of anomalous coronary arteries. [J]Eur Radiol,2004,14:2172-2181
    [1] Guglielmo LDi, Guttadauro, MA.Roentgenologic study of the coronary arteries in the Iiving. [J]Acta Radiol, Suppl,1952,97:1-82
    [2] Whitten MB. A review of the technical methods of demostrating the cireulation of the heart.[J]Arch Int Med,1928,42:846-864
    [3] Jonsson G.Visualization of the coronary arteries. [J]Acta Radiol,1948,29:536-540
    [4] Hoyos JM, Del Campo CG.Angiography of the thoracic aorta and coronary vessels with direct injeetion of an opaque solution into the aorta.[J] Radiology,1948,50:211- 213
    [5] James A,Helmsworth MD,Johnson Mcguire MD,et al.Visualization of the coronary ateries during life.[J]Circulation,1951,3:282-288
    [6]毕莉珠,王锡田.先天性冠状动脉畸形的临床研究[J].心血管病学进展2003,24 ,2:144-148
    [7] Shi H,Aschoff AJ,Brambs HJ,et al.Multislice CT imaging of anomalous coronary arteries.[J]Eur Radiol , 2004 ,14 : 2172-2181
    [8] Rigatelli G, Rigatelli G. Congenital coronary artery anomalies in the adult: a new practical viewpoint. [J]Clin Cardiol, 2005, 28:61-65
    [9] Aydinlar A, Cicek D, Senturk T,etal. Primary congenital anomalies of the coronary arteries: acoronary arteriogramphic study in Western Turkey. [J] Int Heart, 2005, 46:97-103
    [10] Nieman K, Creasing BJ, Van Geuns RJ,et al.Uesfulness of multislice computed tomography for detecting obstructive Coronary disease. [J]Am J Cardionl, 2002, 89: 913- 918
    [11] Kopp AF, Schroder S, Kuettner A,et al.Coronary arteries,retrospectively ECG-gated multi-detecter row CT angiography with selective optinization of the imagine reconst ruction window . [J]Radiology, 2001,221:683-688
    [12] Flohy T,Ohnesorge B.Heart Rate Adaptive Optimization of Spatial and Temporal Resolution for Electrocardeogram-Gated Multislice Spiral CT of the Heart. [J]Journalof Computer Assisted Tomograpby,2001,25 (6) :907-923
    [13] Hong C,Becker CR,Huber A,et al.ECG-gated reconstructed Multl-detector row CT coronary angiography:effect of varying trigger delay on image quality.[J]Radiology, 2001,220(3):712-717
    [14] Kopp AF,Schroeder S,Kuettner A,et al.Coronary arteries:retrospectively ECG-gated multi-detector row CT angiography with selective optimization of the image reconstr-uction window. [J] Radiology,2001,221(3):683-688
    [15] Achenbach S, Giesler T, Ropers D, et al.Comparison of Image Quality in Contrast-en-hanced Coronary artery Visualization by Electron Beam Tomography and Retrospectively Electrocardiogram-gated Multislice Spiral Computed Tomography. [J]Investigative Radiology,2003,38 (2) : 119-128
    [16] Gerber TC, Kuzo RS, Karstaedt N, et al.Current Results and New Development of Coronary Angiography with Use of Contrast-Enhanced Computed Tomography of the Heart. [J]Mayo Clinic Proceedings, 2002,77(1): 55-71
    [17] Wang G, Vanner MW.The effect of pitchin multislice spiral/ helical CT. [J] Med Phys,1999,26: 2648-2653
    [18]毛定飚,滑炎卿,张国真,等.多层螺旋CT评价冠状动脉内软斑块的准确性.中华放射学杂[J], 2006,40:722-725
    [19] Windecker S,Maier-Rudolph W,Bonzel T,et al.Interventional cardiology in Europe 1995. [J]Eur Hear, 1999,20(7):484-495
    [20]陈艳,韩萍.多层螺旋CT冠状动脉成像重建时相及心率对图像质量的影响.中国医学影像技术[J]. 2005 ,21(3):425-428
    [21] Mahnken AH, Wildberger JE, Sinha AM,et al.Value of 3D-Volume Rendering in the Assessment of Coronary Arteries with Retro-spectively ECG-gated Multislice Spiral CT. [J]Acta Radiologica,2003,44(3):302-309
    [22] Ropers D,Baum U,Pohle K,et al.Detection of coronary artery stenoses with thin-slice multi-detector row spiral computed tomography and multiplanar reconstruction. [J]Circulation, 2003, 107(5):664-666
    [23] Cury RC,Ferencik M,Achenbach S,et al.Accuracy of 16-slice multi-detector CT to quantify the degree of coronary artery stenosis:assessment of cross-sectional and longitudinal vessel reconstructions. [J]Eur J Radiol. 2006,57:345-350
    [24]李澄,周丹,杜先懋,等.多层螺旋CT冠状动脉成像的临床应用探讨[J].中国医学计算机成像杂志,2003,9(1):29-33
    [25] Achenbach S,Ulzheimer S,Baum U,et al. Noninvasive coronary an-giography by retrospectively ECG-gated multislice spiral CT. [J]Circulation,2000,102 (2):2823- 2828
    [26]萧毅,田建明,王培军,等.多层螺旋CT冠状动脉造影的扫描技术及临床应用[J].中华放射学杂志,2002,36(4):357-361
    [27] De Feyter PJ, Niemank S,Van Ooijen P,et al.Noninvasive coronary imagining with electron beam computed tomography and magnetic resonance imaging.[J] Heart,2000,84(4):442-448
    [28] Heshui S,Andrik JA , Hans-Juergen B,et al.Multislice CT imaging of anomalous coronary arteries. [J]Eur Radiol ,2004 ,14 (12):2172-2181
    [29] Romano S,Morra A,Del Borrello M,et al.Multi-slice computed tomography and the detection of anomalies of coronary arteries.[J].Cardiovasc Med (Hagerstown), 2008,9 (2):187-194
    [30] Sato Y, Inoue F, Matsumoto N, et al.Detection of anomalous origins of the coronary artery by means of multislice computed tomography.[J]Circ J,2005,69(3):320-324
    [31] Budoff MJ, Ahmed V,et al.Coronary anomalies by cardiac computed tomographic angiography.[J]Clinical Cardiology Volume ,29(11):489-493
    [32] Shi H,Aschoff AJ,Brambs HJ,et al.Multislice CT imaging of anomalous coronary arteries.[J] Eur Radiol,2004,14:2172-2181
    [33]章士正,胡秀华.冠状动脉畸形的16层CT诊断[J].中国医学计算机成像杂志,2005,11(5):325-328
    [34] Serota H,Barth CW,Seuc C,et al.Rapid identification of the course of anomalous coronary arteries in adults:The "dot and eye" method.[J]Am J Cardiol,1990, 65(13): 891-898
    [35]王照谦,杨志强,朱皓,等.多层螺旋CT诊断冠状动脉起源异常的价值[J].中华医学杂志,2005,40:80-82
    [36] Yamanaka O,Hobbs RE.Coronary artery anomalies in 126,595 patients undergoing coronary arteriography.[J]Cathet Cardiovasc Diagn 1990,21(1): 28-40
    [37]张海刚,陈鲁原.39例成人冠状动脉瘘临床分析[J].中国临床医学,2004,11 :709-711

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700