| Objectives On the basis of calculating the degrees of stenosis and plaque of coronary,intracranial and carotid artery by 256 slice spiral computed tomography angiography.The distribution of different types of plaques in different arterial segments was explored.The relationships among stenosis and plaque calcification of coronary,intracranial and carotid artery and their predictive value on coronary heart disease were also analyzed.Methods The retrospective case-control study was used in this research.Patients with or suspected as coronary heart disease were selected as the subjects.The coronary,intracranial and carotid artery of all patients were examined by tomography angiography.Besides,the stenosis and calcification scores in each arterial segment were calculated by extended brillian workspace.All patients were divided into two groups by the examination of coronary angiography.Degree of stenosis 50% or higher as the case group,the degree of stenosis < 50% for the control group.The epidemiological data and stenosis and plaque calcification scores in each arterial segment were compared between two groups.A logistics regression model was used to analyze the predictive value of coronary,intracranial and carotid artery stenosis and calcification scores on coronary heart disease.Results There were 207 patients in the research.The control group included 129 patients and case group included 78 patients.There were significant differences in smoke,hypertension,atrial fibrillation and family history of coronary heart disease between two groups.There were 230 stenotic segments in 2905 coronary artery segments.The main parts of stenosis in coronary artery were left anterior descending and left circumflex segment(accounted for 38.0%).The main property of plaque in coronary artery was calcified plaque.The stenosis and calcification scores of coronary artery in control group were both lower than that in case group(0.94±1.59 vs.9.96±3.62,Z=-12.207,P<0.001;1.32±4.25 vs.12.85±21.67,Z=-5.242,P<0.001 c There were 21 stenotic segments in 1236 intracranial artery segments.The main part of stenosis in intracranial artery was intracranial segment of vertebral artery.The main property of plaque in intracranial artery was soft plaque(accounted for 42.9%).The stenosis and calcification scores of intracranial artery in control group were both lower than that in case group(0.05±0.25 vs.0.37±0.78,Z=-4.111,P<0.001;0.11±0.54 vs.0.47±0.92,Z=-3.903,P<0.001).There were 86 stenotic segments in 828 carotid artery segments.The main part of stenosis in carotid artery was common carotid segment.The main property of plaque in carotid artery was also calcified plaque(accounted for 49.4%).Just as coronary and intracranial artery,the stenosis and calcification scores of carotid artery in control group were both lower than that in case group(0.04±0.11 vs.0.20±0.20,Z=-7.696,P<0.001;0.50±1.27 vs.1.90±1.50,Z=-7.051,P<0.001).The influencing factors of diagnosing coronary heart disease were stenosis score of coronary artery,plaque calcification score of coronary artery and stenosis score of carotid artery(95%OR=1.877~5.133,P<0.001;95%OR=1.021~1.232,P=0.017;95%OR=4.772 ~ 5.061*106,P=0.016).The stenosis score in coronary,intracranial and carotid artery all had significant relation with their own calcification score.In addition,the stenosis score of coronary artery had positive correlation with the stenosis score of carotid artery,calcification score of carotid artery and intracranial artery.Conclusions The stenosis and calcification scores of coronary,intracranial and carotid artery calculated by computed tomography angiography are still high in the patients diagnosed by coronary angiography.The main factors influencing coronary heart disease are stenosis score of coronary artery,calcification score of coronary artery and stenosis score of carotid artery.The stenosis of coronary artery has an obvious relationship with plaque calcification of intracranial and carotid artery. |
