【摘要】 目的　探讨年龄和性别在电子束CT(EBCT)测定冠状动脉钙化 (CAC)程度及其对冠心病诊断价值的影响。方法　 2 6 4 2例患者行EBCT检测CAC并计算每例的总积分 ,分析年龄和性别与CAC检测阳性率及CAC总积分的关系 ;其中同期经选择性冠状动脉造影检查的患者 4 32例 ,评价CAC对冠心病的诊断价值及年龄和性别的影响。结果　 (1) 2 6 4 2例患者总的检测阳性率为 6 9.3% ,其中男性和女性分别为 73.1%和 6 0 .4 % ,阳性率男性显著高于女性 (P <0 .0 0 1)。两性的阳性率都随年龄增大而增高 ;70岁以下各年龄组男性均明显高于女性 ,但 6 0岁以后两性差距逐渐缩小 ,70岁以上各年龄组两性间比较 ,差异无显著性 ;(2 )男女两性钙化积分的自然对数转换值的均数都随年龄增大而增高 ,性别差异与年龄阳性率相似 ;(3)CAC诊断冠心病的敏感性、特异性、阳性预测值和阴性预测值分别为 91%、5 1%、79%和 74 %。按年龄和性别分组后 ,CAC诊断冠心病的敏感性在≥ 6 0岁男性组最高 ,<6 0岁女性组最低 ;而诊断特异性则与之相反。结论　冠状动脉钙化程度随年龄增长而加重 ,男性一般重于同龄女性 ,但 6 0岁以后女性钙化程度迅速增加并逐渐接近同龄男性 ;年龄和性别对冠状动脉钙化诊断冠心病的价值有很大影响更多还原

【Abstract】 Objective To investigate the influence of age and gender on the extent of coronary artery calcification (CAC) determined by electron beam computed tomography(EBCT) and on the value of CAC for diagnosing coronary artery disease. Methods EBCT was performed for detecting CAC in 2 642 patients and the total calcium score (CS) was calculated separately for each patient. The correlation of age and gender with CAC incidence rate and CS was analyzed. In 432 patients undergoing selective coronary angiography within one month of EBCT scanning,the influence of age and gender on the value of CAC for diagnosis of coronary artery disease was evaluated. Results (1) The total prevalence of CAC was 69.3%, whereas it was 73.1% in men and 60.4% in women ( P <0.001). The prevalence increased with aging in both genders. For each age group before 70 years the prevalence was significantly higher in men than in women, but from 60 to 70 years, the difference between genders gradually diminished, and it had no significant difference between genders after 70 years. (2) The mean of the natural logarithm transformation of CS (LN) increased with aging for both genders, and the differences of LN between genders were similar to those of CAC prevalence. (3)The sensitivity, specificity, positive predictive value and negative predicitive value of CAC for diagnosis of coronary artery disease were 91%, 51%, 79% and 74%, respectively. Compared among the groups, the sensitivity of CAC for diagnosis of coronary artery disease was highest in men ≥60 years old ,and the lowest was in women<60 years old. In contrast, the specificity was highest in women <60 years old , and the lowest was in men ≥60 years old. Conclusions The extent of coronary artery calcification is aggravated with aging. In general, the CAC extent in women is less than in men of the same age group, but it quickly increases after their sixth teens and gradually gets close to the same aged men. Age and gender have great effect on the value of coronary calcium for diagnosis of coronary artery disease.更多还原