2型糖尿病患者64层螺旋CT冠状动脉造影表现的研究

摘要

Objective:To evaluate the value of of 64-slice CT coronary angiography in detecting the degree of coronary artery stenosis and the plaque character and to esrimate the danger of coronary artery disease in patients with type-2 diabetes mellitus (DM). Methods; 200 patients who underwent 64-slice spiral CT coronary angiography were divided into type-2DM group (n＝100) and non-DM (n＝ 100) group to detect the stenosis degree and characterizations of atherosclerosis plaque in coronary artery. And type-2-DM group was further divided into 3 sub-groups: 0～6 year. 6～14 year. ＞ 14year. Results : The type-2-DM group had more ill artery than non-DM group ( P ＜0. 05) ; and number of single-artery disease was fewer than non-DM group ( P ＜0. 05) ; rate of three-vessel involved was 36. 9％in type-2 DM group and 33. 5％in non-type-2 DM ( P ＜0. 05). The serious stenosis of type-2 DM group was more than non-DM group ( P ＜0. 01). In 0～6 year-group febric plaque was prior and sight and medium stenosis was found; febric and mixed plaque was prior in 6～14-group and medium and severe stenosis was found; in ＞14-group extensive calcium plaque was found. Logistic analysis showed that was obvious correlation between type-2 DM and coronary heart disease. Conclusion: There is a great danger of coronary heart disease in DM patients and more severe with the duration. 64-slice CT can sufficiently detect the degree of coronary artery disease and the characterization of atherosclerosis plaque characterization in DM patients ; and it has a great value in diagnosing coronary artery disease and evaluating the risk in clinical heart disease patients.%目的:评价64层螺旋CT冠状动脉造影检测2型糖尿病患者冠脉病变程度、冠脉内斑块性质的价值;评估2型糖尿病患者冠状动脉病变发生的危险性.方法:收集200例患者(糖尿病组100例,非糖尿病组100例)64层螺旋CT冠状动脉成像资料,并根据糖尿病患者发病年限将2型糖尿病组分成3组:O～6年、6～14年、＞14年,对冠状动脉狭窄程度及斑块性质进行评价.结果:2型糖尿病组血管病变支数明显多于非2型糖尿病组(P＜0.01),2型糖尿病组单支病变明显少于非糖尿病组(P＜0.05);糖尿病组三支病变发生率为36.9%,而非糖尿病组发生率为33.5%,两组比较差异有统计学意义(P＜0.05).2型糖尿病组重度狭窄病变明显多于非糖尿病组(P＜0.05).研究显示:0～6年组冠脉病变以纤维斑块为主,管腔以轻中、度狭窄为主;6～14年组病变以纤维斑块和混合斑块为主,管腔呈中、重度狭窄:＞14年组病变以弥漫钙化为主,管腔呈中、重度狭窄.Logistic分析表明2型糖尿病与冠状动脉病变密切相关.结论:2型糖尿病患者有高度的冠状动脉病变危险性,且随患病年限延长病变加重.64层螺旋CT是糖尿病患者诊断冠状动脉病变可靠的、无创的检查方法,可有效检测糖尿病患者冠状动脉病变的程度和冠脉斑块性质,对冠心病诊断和临床评估冠心病风险具有重要价值.