天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (6): 527-530.

• 临床研究 • 上一篇    下一篇

右冠脉起始部-主动脉夹角与右冠脉斑块成分及 狭窄程度的关系探讨

王星 1,2，顾隽珩 2，张洪 2，张颖 3，李东 4△
  

  1. 1 天津医科大学研究生院（邮编 300070）；2 天津市胸科医院影像科，3 心内科；4 天津医科大学总医院放射科
  • 收稿日期:2019-12-25 修回日期:2020-04-20 出版日期:2020-06-15 发布日期:2020-06-15
  • 通讯作者: 王星 E-mail:wang1985xing@126.com
  • 基金资助:
    天津市卫生行业重点攻关项目;天津市科技计划项目

The relationship between right coronary artery-aortic angle, right coronary plaque components and its stenosis

WANG Xing1,2, GU Jun-heng2, ZHANG Hong2, ZHANG Ying3, LI Dong4△ #br#   

  1. 1 Graduate School of Tianjin Medical University, Tianjin 300070, China; 2 Department of Imaging, 3 Department of
    Cardiology, Tianjin Chest Hospital; 4 Department of Radiology, General Hospital of Tianjin Medical University
  • Received:2019-12-25 Revised:2020-04-20 Published:2020-06-15 Online:2020-06-15

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摘要： 摘要：目的 通过冠状动脉CT血管成像（CCTA）初步探究右冠状动脉（RCA）起始部-主动脉夹角与RCA斑块成 分及狭窄程度的关系。方法 连续纳入631例于我院行CCTA检查患者进行回顾性分析，根据RCA起始部有无斑块 将其分为正常组（n=279）和斑块组（n=352），斑块组基于不同斑块成分CT值的不同，进一步分为钙化斑块组（n=72）、 非钙化斑块组（n=181）及混合斑块组（n=99）。根据RCA有无狭窄分为无狭窄组（n=383）及狭窄组（n=248），狭窄组进 一步分为＜50%狭窄组及≥50%狭窄组。比较正常组与不同斑块成分各组之间、无狭窄组及不同狭窄程度各组之间 RCA起始部-主动脉夹角的差异。结果 正常组男性RCA起始部-主动脉夹角明显大于女性（P＜0.05）。非钙化斑 块组、混合斑块组RCA起始部-主动脉夹角小于正常组（P＜0.05），钙化斑块组与其他各组相比差异均无统计学意 义。与无狭窄组比较，＜50%狭窄组及≥50%狭窄组RCA起始部-主动脉夹角均减小（P＜0.05），＜50%狭窄组及≥ 50%狭窄组RCA起始部-主动脉夹角差异无统计学意义。结论 RCA起始部-主动脉夹角较小时，易形成非钙化及 混合斑块，平扫CT如发现RCA起始部-主动脉夹角较小时则提示RCA存在斑块及狭窄可能。

关键词: 冠状动脉狭窄, 斑块, 动脉粥样硬化, 右冠状动脉, 冠状动脉CT血管成像, 右冠状动脉（RCA）起始部-主
动脉夹角

Abstract: Abstract: Objective To preliminary investigate the relationship between right coronary artery (RCA) origin-aortic angle, RCA plaque composition and coronary artery stenosis by coronary CT angiography (CCTA). Methods A total of 631 consecutive patients undergoing CCTA examination in our hospital were retrospectively analyzed. According to the presence or absence of RCA plaques, patients were divided into normal group (n=279) and plaque group (n=352). The plaque group was further divided into calcified group (n=72), non-calcified group (n=181) and mixed plaque group (n=99) based on the different CT values of different plaque components. According to the presence or absence of RCA stenosis, the patients were divided into non-stenosis group (n=383) and stenosis group (n=248). The stenosis group was further divided into ＜50% stenosis group and ≥50% stenosis group. The differences of the RCA origin-aortic angle were compared between normal group and plaque groups, and between no stenosis group and stenosis groups. Results In the normal group, the angle of the RCA origin-aorta was significantly larger in males than that of females (P＜0.05). The RCA origin-aortic angles of noncalcified plaque group and mixed plaque group were both smaller than that of normal group (P＜0.05). There were no significant differences in RCA origin-aortic angles between calcified plaque group and the other groups. Compared with nonstenosis group, the angles of RCA origin-aorta were reduced in both the ＜50% stenosis group and ≥50% stenosis group (P＜ 0.05). There was no statistically significant difference in the RCA origin-aortic angle between the ＜50% stenosis group and ≥50% stenosis group. Conclusion Non-calcified and mixed plaques are prone to form when the angle between the RCA origin and the aorta is smaller. If the plain CT scan shows that the angle is smaller, it indicates that plaque and stenosis may exist in the RCA.

Key words: coronary stenosis, plaque, atherosclerotic, right coronary artery, coronary computed tomography
angiography, right coronary artery origin-aortic angle