2型糖尿病患者64层螺旋CT冠状动脉造影表现的研究  

The research of the morphology in patients with type-2 mellitus diabetes patients by 64-slice CT coronary angiography

作　　者：付玉存[1] 刘大亮[1] 秦雷[1] 史朴军[1] 马勇[1] 魏里[1] 

机构地区：[1]山东省聊城市人民医院CT室,山东聊城252000

出　　处：《医学影像学杂志》2011年第2期201-205,共5页Journal of Medical Imaging

摘　　要：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：0-6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。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 estimate 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-2 DM 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,〉14 year.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.

关 键 词：糖尿病 2型 体层摄影术 X线计算机 冠状动脉造影术 

分 类 号：R445[医药卫生—影像医学与核医学] R587.1[医药卫生—诊断学]