新疆汉族、维吾尔族左冠状动脉分叉夹角及左主干长度与夹角区动脉粥样硬化的MSCT相关性研究

刘晓蓓; 潘存雪; 刘文亚

doi:10.13418/j.issn.1001-165x.2018.02.008

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (2) : 158-161. DOI: 10.13418/j.issn.1001-165x.2018.02.008

断层影像解剖

新疆汉族、维吾尔族左冠状动脉分叉夹角及左主干长度与夹角区动脉粥样硬化的MSCT相关性研究

刘晓蓓，　潘存雪，　刘文亚

作者信息 +

The relationship between bifurcation angle and main trunk length and atherosclerosis of left coronary artery in Uighur and Han

LIU Xiao-bei, PAN Cun-xue, LIU Wen-ya

Author information +

文章历史 +

摘要

目的　利用MSCT分析维吾尔族与汉族左冠状动脉分叉夹角（LAD-LCX）及左主干长度（LM）与冠状动脉夹角区动脉粥样硬化的关系。方法　回顾性分析本地区6所医院行冠状动脉CTA检查患者资料，将左冠状动脉主干分叉区按管腔狭窄受累情况分为Ⅰ~Ⅳ级，分析比较维吾尔族及汉族不同分级之间的左冠状动脉分叉夹角及左主干长度差异；分析左冠状动脉分叉夹角与左主干长度的相关性。结果　纳入研究1276例，汉族916例，维吾尔族360例。汉族左冠状动脉夹角均值为(84±38.8)º(29º~158º), 左冠状动脉主干长度均值为(9.2±5.3)mm(1.6~28.6 mm)；维吾尔族左冠状动脉夹角均值为(85±34)º(24º~155º)，LM长度均值为(9.6±6.6)mm(2.4~18.3mm)。维吾尔族与汉族的左冠状动脉夹角在Ⅰ级与Ⅱ、Ⅲ、Ⅳ级之间差异有统计学意义，而Ⅱ、Ⅲ、Ⅳ级之间的左冠状动脉夹角差异无统计学意义。两民族左冠状动脉分叉夹角与左冠状动脉主干长度均呈中度相关(汉族R=0.307;维吾尔族R=0.421)。结论　大的冠状动脉夹角及更长的左主干长度更容易引起夹角区冠状动脉硬化，但与夹角区管腔受累程度没有明显相关性；左冠状动脉分叉夹角与左冠状动脉主干长度呈中度相关,维吾尔族略高于汉族。

Abstract

Objective　To analyzed the relationship between the bifurcation angle and the length of the main trunk and the atherosclerosis of the left Coronary artery in Uighur and Han by MSCT.　Methods Coronary artery CTA imaging data of six hospitals from 2013.6 to 2014.12 was retrospectively analyzed. Patients were classified asⅠ~Ⅳ types according to the degree of luminal stenosis of at the left coronary bifurcation region. Comparison the different types of the bifurcation angle, and the relationship between the bifurcation angle and the length of the main trunk of the left Coronary artery was performed.　Results　The study enrolled 1276 cases, in which 916 cases were of Han ethnicity, and 360 cases of Uighur ethinicity. The bifurcation angle of Han was (84±38.8)º , with a range of (29º~158º); the length of the main trunk was (9.2±5.3) mm, with a range (1.6~28.6 mm); In Uighur the bifurcation angle was (85±34)º, with a range (24º~155º); the length of main trunk length was (9.6±36.6) mm, with a range (2.4~18.3 mm). There was significant difference amongⅠand Ⅱ, Ⅲ and Ⅳ types and no significant difference among Ⅱ, Ⅲ or Ⅳ types in either Han or Uighur ethnicity. There was moderate correlation between the bifurcation angle and the length of the main trunk of the left coronary artery (Han R= 0.307; Uighur R=0.421).　Conclusion　A larger left coronary bifurcation angle and a greater length of the left main trunk are more likely to cause coronary artery atherosclerosis in the bifurcation region, but there is no significant correlation with the degree of luminal stenosis. The left coronary bifurcation angle is moderately related to the length of the main trunk of the left coronary artery, and the Uighur is slightly higher than Han.

导出引用

刘晓蓓,潘存雪,刘文亚. 新疆汉族、维吾尔族左冠状动脉分叉夹角及左主干长度与夹角区动脉粥样硬化的MSCT相关性研究[J]. 中国临床解剖学杂志. 2018, 36(2): 158-161 https://doi.org/10.13418/j.issn.1001-165x.2018.02.008

LIU Xiao-bei, PAN Cun-xue, LIU Wen-ya. The relationship between bifurcation angle and main trunk length and atherosclerosis of left coronary artery in Uighur and Han[J]. Chinese Journal of Clinical Anatomy. 2018, 36(2): 158-161 https://doi.org/10.13418/j.issn.1001-165x.2018.02.008

参考文献

[1] Chaichana Z, Sun Z, Jewkes J. Computation of hemodynamics in the left coronary artery with variable angulations [J]. J Biomech, 201 l, 44(10):1869-1878.
[2] Zhang D, Dou K. Coronary bifurcation intervention: what role do bifurcation angles play[J]? Interv Cardiol , 2015, 28(3):236-248.
[3] Dong J, Sun Z, Inthavong K, et al. Fluid-structure interaction analysis of the left coronary artery with variable angulation [J]. Comput Methods Biomech Biomed Eng, 2015, 18(14):1500-1508.
[4] Chaichana T, Sun Z, Jewkes J. Hemodynamic analysis of the effect of different types of plaques in the left coronary artery[J]. Comput Med Imaging Graph, 2013, 37(3):197-206.
[5] Reig J, Petit M. Main trunk of the left coronary artery: anatomic study of the parameters of clinical interest[J] .Clin Anat, 2004, 17(1):6-13.
[6] Djaberi R, Schuijf JD, van Werkhoven JM, et al. Relation of epicardial adipose tissue to coronary atherosclerosis[J]. Am J Cardiol, 2008, 15, 102(12):1602-1607.
[7] Cury RC, Abbara S, Achenbach S, et al. Coronary artery disease - reporting and data system (CAD-RADS): an expert consensus document of SCCT, ACR and NASCI: endorsed by the ACC[J]. JACC Cardiovasc Imaging, 2016, 9(9):1099-1113.
[8] Pontone G, Andreini D, Bartorelli AL, et al. Radiation dose and diagnostic accuracy of multidetector computed tomography for the detection of significant coronary artery stenoses: a meta-analysis[J]. Int J Cardiol, 2012, 160(3): 155-164.
[9] Papadopoulou SL, Brugaletta S, Garcia-Garcia HM, et al. Assessment of atherosclerotic plaques at coronary bifurcations with multidetector computed tomography and intravascular ultrasound-virtual histology[J]. Eur Heart J Cardiovasc Imaging, 2012, 13(8): 635-642.
[10] Rubinshtein R, Lerman A，Spoon DB，et a1. Anatomic features of the left main coronary artery and factors associated with its bifurcation angle：a 3-dimensional quantitative coronary angiographic study[J]．Catheter Cardiovasc Interv, 2012, 80(2):304-309.
[11]Temov K, Sun Z. Coronary computed tomography angiography investigation of the association between left main coronary artery bifurcation angle and risk factors of coronary artery disease[J]. Int J Cardiovasc Imaging, 2016, 32 (1):129-137.