多层螺旋CT对老年糖尿病患者冠状动脉病变筛查的研究

摘要

Objective To evaluate the clinical value of multi-slice spiral CT (MSCT)in the screening of coronary artery lesions in elderly patients with diabetes mellitus.Methods MSCT and coronary angiography(CAG)were performed in 136 elderly patients(68 patients with diabetes and 68 patients without diabetes).The number of diseased coronary segments and the plaque type (noncalcified,mixed and calcified)for each patient were determined.The characteristics of coronary lesions were compared between patients with and without diabetes.The sensitivity and specificity of MSCT were evaluated.Results More noncalcified and calcified plaques and few ermixed plaques were observed in patients with diabetes,compared with patients without diabetes(noncalcified plagues:10 cases or 14.7％ vs.4 cases or 5.9％;calcified plagues:47 cases or 69.1％ vs.39 cases or 57.4％)(P＜ 0.05).In addition,diabetic patients showed a significantly higher frequency of multivessel disease(P＜0.05).Furthermore,MSCT was able to clearly show stenosis and plaque type in the trunk and branches of the coronary artery,with a sensitivity of 91.0％,a specificity of 95.0％,a positive predictive value of 93％ and a negative predictive value of 96.0％.Conclusions Diabetes is associated with a higher risk of coronary artery disease.MSCT can effectively detect the characteristics of coronary artery disease in diabetic patients and is an effective,noninvasive,and safe screening method.%目的 评价多层螺旋CT(MSCT)在老年糖尿病患者冠状动脉(冠脉)病变筛查中的临床应用价值. 方法 136例老年患者,其中糖尿病组和非糖尿病患者各68例,分别行MSCT冠脉血管成像检查和冠脉造影(CAG).分析各组患者冠脉病变特点,评价MSCT的灵敏度和特异性.结果 糖尿病组患者非钙化性和钙化性斑块数均高于非糖尿病组,分别为14.7％(10例)和5.9％(4例)、69.1％(47例)与57.4％(39例),差异有统计学意义(P＜0.05),而混合性斑块低于非糖尿病组,且糖尿病组患者的冠脉病变多呈多支病变.MSCT诊断冠脉病变的敏感度为91.0％,特异度为95.0％,阳性预测值为93.0％,阴性预测值为96.0％. 结论 糖尿病患者具有更高的冠脉病变风险,MSCT可有效检测糖尿病患者的冠脉病变特点,是一种有效、无创、安全的筛查手段.