慢性阻塞性肺部疾病中放射检测冠状动脉疾病的患病率和临床相关性:一个跨部分观察性研究
Mairi A MacLeod1, Kristopher D Knott2, James P Allinson3,4
1Imperial College London National Heart and Lung Institute, Airways disease, London, United Kingdom of Great Britain and Northern Ireland.
冠状动脉疾病 (CAD) 在慢性阻塞性肺病 (COPD) 患者中非常普遍,通常没有症状. 胸部CT扫描可以有效地选这种隐藏的CAD,改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 放射学 放射学是一门学科.
背景情况:
- 未被识别的冠状动脉疾病 (CAD) 与慢性阻塞性肺病 (COPD) 患者的不良结果有关.
- 早期识别患有慢性肺炎风险的个人对于实施预防策略至关重要.
- 目前在COPD患者中对CAD的查方法可能不足.
研究的目的:
- 确定COPD患者中可放射检测的CAD的患病率和特征.
- 在这个人群中评估隐性 (未诊断) CAD 的频率.
- 评估COPD患者不同心血管查方法的有效性.
主要方法:
- 使用计算机断层扫描 (CT) 对50名COPD患者和匹配的对照进行前性评估.
- 在COPD患者中评估CAD与心脏症状,功能能力,恶化和炎症标志物的关系.
- 使用ROC曲线评估查测试,包括心血管风险得分,生物标志物和胸部CT衍生的冠状动脉分数.
主要成果:
- 在88%的COPD患者中检测到CAD,其中42%患有阻塞性疾病和28%患有严重阻塞性疾病,明显高于对照组.
- 阻塞性CAD在COPD患者中更常见 (OR 3.1) 和严重阻塞性CAD更常见 (OR 10.1).
- CAD与功能障碍和全身炎症相关,但通常不与胸痛或呼吸障碍相关;胸部CT衍生冠状动脉分数显示为查的高疗效.
结论:
- CT冠状动脉扫描显示,COPD患者的CAD负担很高,经常无症状,传统风险评分无法检测到.
- 标准的胸部CT扫描,特别是冠状动脉分数,显示出作为COPD中CAD有效查工具的希望.
- 在COPD患者中改善CAD的放射性查可能会导致更好的检测和潜在的改善临床结果.
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