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低剂量CT肺癌筛查中冠状动脉钙化的患病率及危险因素

[Prevalence and risk factors of coronary artery calcification on lung cancer screening with low-dose CT].

作者信息

Zhang Z W, Jin Y J, Zhao S J, Zhou L N, Huang Y, Wang J W, Tang W, Wu N

机构信息

Department of Nuclear Medicine, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021 China.

Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2022 Oct 23;44(10):1112-1118. doi: 10.3760/cma.j.cn112152-20201114-00986.

Abstract

To investigate the prevalence and risk factors of coronary artery calcification (CAC) on lung cancer screening with low-dose computed tomography (LDCT). A total of 4 989 asymptomatic subjects (2 542 males and 2 447 females) who underwent LDCT lung cancer screening were recruited at Cancer Hospital, Chinese Academy of Medical Sciences from 2014 to 2017. The visual scoring method was used to assess coronary artery calcification score. (2) test or independent -test was used to compare the difference of CAC positive rate among different groups. Multivariate logistic regression was used to analyze risk factors associated with CAC in the study. Of the 4 989 asymptomatic subjects, CAC occurred in 1 018 cases. The positive rate was 20.4%, of which mild, moderate and severe calcification accounted for 86.3%, 11.4% and 2.3%, respectively. Gender, age, BMI, education level, occupation, smoking history, diabetes, hypertension and hyperlipidemia had statistically significant differences in CAC positive rates among groups. Multivariate logistic regression analysis showed that gender, age, diabetes, hypertension, hyperlipidemia and smoking history were risk factors for CAC. Age, diabetes, hypertension and smoking history were statistically significant risk factors between the mild and moderate CAC group. A total of 1 730 coronary arteries in 1 018 CAC positive cases had calcification, CAC positive rate of left anterior descending was the highest(51.3%); 568 cases (55.8%) were single vessel calcification, 450 cases (44.2%) were multiple vessel calcification. LDCT can be used for the 'one-stop' early detection of lung cancer and coronary atherosclerosis. Gender, age, diabetes, hypertension, hyperlipidemia and smoking are related risk factors for coronary atherosclerosis.

摘要

探讨低剂量计算机断层扫描(LDCT)肺癌筛查中冠状动脉钙化(CAC)的患病率及危险因素。2014年至2017年,在中国医学科学院肿瘤医院招募了4989例接受LDCT肺癌筛查的无症状受试者(男性2542例,女性2447例)。采用视觉评分法评估冠状动脉钙化积分。采用卡方检验或独立样本t检验比较不同组间CAC阳性率的差异。采用多因素logistic回归分析本研究中与CAC相关的危险因素。在4989例无症状受试者中,1018例发生CAC。阳性率为20.4%,其中轻度、中度和重度钙化分别占86.3%、11.4%和2.3%。性别、年龄、体重指数、教育程度、职业、吸烟史、糖尿病、高血压和高脂血症在各组间CAC阳性率上有统计学显著差异。多因素logistic回归分析显示,性别、年龄、糖尿病、高血压、高脂血症和吸烟史是CAC的危险因素。年龄、糖尿病、高血压和吸烟史在轻度和中度CAC组间是有统计学意义的危险因素。1018例CAC阳性病例中共有1730支冠状动脉发生钙化,左前降支CAC阳性率最高(51.3%);单支血管钙化568例(55.�%),多支血管钙化450例(44.2%)。LDCT可用于肺癌和冠状动脉粥样硬化的“一站式”早期检测。性别、年龄、糖尿病、高血压、高脂血症和吸烟是冠状动脉粥样硬化的相关危险因素。

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