Konieczyńska Małgorzata, Tracz Wiesława, Pasowicz Mieczysław, Przewłocki Tadeusz
Ośrodek Diagnostyki i Rehabilitacji Chorób Serca i Płuc Krakowskiego Szpitala Specjalistycznego im. Jana Pawła II, ul. Pradnicka 80, 31-280 Kraków.
Kardiol Pol. 2006 Oct;64(10):1073-9; discussion 1080-1.
Increased cardiovascular morbidity leads to search for new, non-invasive diagnostic methods for early detection of atherosclerosis. Among others computed tomography has become a matter of interest. The usefulness of quantitative analysis of calcification using multislice spiral computed tomography (MSCT) in cardiology has been studied recently.
To evaluate the usefulness of calcium score (CS), estimated with MSCT, in identifying the risk of coronary artery stenosis.
The analysis involved 340 consecutive patients, 222 men and 118 women, mean age 59.7+/-9.38 years. All patients were admitted to hospital with symptoms of coronary artery disease for coronary angiography. In all subjects risk factor assessment and CS estimation using MSCT were performed.
Mean CS was 271.1+/-605.9 and it increased with the progression of coronary artery disease. The differences between mean CS values in patients without coronary stenosis and patients with 1-, 2- or 3-vessel disease varied significantly (p <0.001). The cut-off point for total CS for the presence of coronary artery stenosis in the study group was set at > or =56 (sensitivity 85.7% and specificity 85.3%). The likelihood of the absence of significant stenosis (negative predictive value) in the whole study group was 93.5% and in women reached 100%.
Coronary calcium score is a valuable parameter in assessing the likelihood of presence of coronary stenosis. The absence of calcifications in coronary arteries (CS=0) excludes significant coronary stenosis with a high probability.
心血管疾病发病率的增加促使人们寻找新的、非侵入性的早期动脉粥样硬化诊断方法。其中，计算机断层扫描已成为一个研究热点。近年来，多层螺旋计算机断层扫描（MSCT）在心脏病学中对钙化进行定量分析的实用性已得到研究。
评估通过MSCT估算的钙评分（CS）在识别冠状动脉狭窄风险方面的实用性。
分析纳入了340例连续患者，其中男性222例，女性118例，平均年龄59.7±9.38岁。所有患者因冠心病症状入院接受冠状动脉造影。对所有受试者进行了危险因素评估以及使用MSCT估算CS。
平均CS为271.1±605.9，且随着冠状动脉疾病的进展而增加。无冠状动脉狭窄患者与单支、双支或三支血管病变患者的平均CS值差异有统计学意义（p<0.001）。研究组中冠状动脉狭窄存在时总CS的截断点设定为≥56（敏感性85.7%，特异性85.3%）。整个研究组中无明显狭窄的可能性（阴性预测值）为93.5%，女性达到100%。
冠状动脉钙评分是评估冠状动脉狭窄可能性的一个有价值的参数。冠状动脉无钙化（CS=0）极有可能排除明显的冠状动脉狭窄。
