目的：探讨尿毒症与非尿毒症患者胸部CT心血管钙化发病率的特点。方法：选择66例连续行胸部CT检查的尿毒症患者为观察组，随机抽取同期66例非尿毒症患者为对照组，对所有患者均行16排螺旋CT常规扫描，观察两组患者有无心脏瓣膜、冠状动脉及主动脉弓钙化。结果：观察组有钙化者38例(占58%)，对照组12例(占18%)，两组差异有统计学意义(x2=21.76，P＜0.05)。观察组主动脉弓钙化22例(占33%)，对照组8例(占12%)，两组差异有统计学意义(x2=8.46，P＜0.05)。观察组瓣膜钙化8例(占12%)，对照组无瓣膜钙化，两组差异有统计学意义(x2=8.52，P＜0.05)。观察组冠状动脉钙化30例(占45%)，对照组8例(占12%)，两组差异有统计学意义(x2=17.89，P＜0.05)。观察组前降支钙化28例(占42%)，对照组7例(占11%)，两组差异有统计学意义(x2=17.15，P＜0.05)。观察组左旋支钙化8例(占12%)，对照组无左旋支钙化，两组差异有统计学意义(x2=8.52， P＜0.05)。观察组右冠状动脉钙化16例(占24%)，对照组4例(占6%)，两组差异有统计学意义(x2=8.49，P＜0.05)。结论：尿毒症患者心血管钙化的发病率明显高于非尿毒症患者，钙化主要累及主动脉弓及前降支，提示尿毒症患者心血管壁受累有较高的发生率，冠心病的发病率亦增高。CT是发现尿毒症患者心血管钙化的主要检查方法，可作为尿毒症性心脏病的筛选手段。%Objective: To investigate the characteristics of cardiovascular calcification in chest CT of uremic patients and non-uremic patients. Methods: Sixty-six consecutive uremic patients were enrolled into the study group. Meanwhile, 66 non-uremic patients at the same period were randomly enrolled into the control group. All patients underwent routine chest CT with16-slice spiral CT system ranging from the apex to the bottom. Two senior physicians review the images to determine whether or not there were the calcification of the heart valves, coronary and aortic arch, by which the patients were grouped. Results:The study group had calcification in 38 patients (58%), significantly higher than the control group (12,18%), x2=21.76, P=0.001<0.05. The study group had aortic arch calcification in 22 cases (33%), higher than the control group (8,12%), x2= 8.46, P=0.004<0.05. The study group had valvular calcification in eight cases (12%) , No valvular calcification was found in the control group, x2=8.52, P=0.004<0.05. Study Group had 30 cases of coronary artery calcification (45%), significantly higher than 8 cases (12%) in the control group, x2=17.89, P=0.001<0.05. Study group had calcification of Left anterior descending artery in 28 cases (42%), significantly higher than 7 cases (11%) in the control group, x2=17.15, P=0.001<0.05. Study Group had left circumflex artery calcification in 8 cases (12%), no calcification of the left circumflex artery was demonstrated in the control group, x2=8.52, P=0.004<0.05. Study group had right coronary artery calcification in 16 patients (24%), higher than 4 cases (6%) in the control group, x2=8.49, P=0.004<0.05. Conclusion: The incidence of cardiovascular calcification in uremic patients was significantly higher than that in the non-uremic patients, which mainly involving the aortic arch and the left anterior descending artery, suggesting a higher incidence of coronary heart disease in uremic patients. CT is the primary method for detecting cardiovascular calcification in uremic patients, therefore can be used as a screening tool for uremic heart disease.
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