320排CT在糖尿病冠状动脉粥样硬化斑块形态学及管腔重构的研究  

Assessment on 320-rows coronary computed tomography angiography differences in morphology of coronary atherosclerotic plaques and vascular remodeling in diabetes and non-diabetes

作　　者：董莘[1] 秦崇[1] 时文伟 敖国昆[1] 

机构地区：[1]解放军第309医院放射科,北京100091

出　　处：《中国医学装备》2014年第3期62-66,共5页China Medical Equipment

摘　　要：目的:评估糖尿病(DM)和无DM患者320排冠状动脉CT造影(CCTA)冠状动脉粥样硬化斑块形态学及管腔重构的不同。方法:比较由于胸痛和冠心病的筛查而接受320排CCTA检查的232例DM患者和487例无DM患者的冠状动脉粥样硬化斑块形态学及管腔重构。结果:DM患者与无DM患者相比较,DM患者单支血管病变发生率低(x^2=5.434,P<0.05);2支血管病变发病率相似(x^2=0.912,P>0.05);而3、4支血管病变发病率高(x^2=4.887,P<0.05);单因素分析显示,DM组混合性斑块、梗阻性斑块以及阳性重构(PR)发病率高(x^2=4.214,x^2=4.415,x^2=6.215;P<0.05),而多因素Cox比例风险回归模型分析显示,仅PR与DM呈正相关(危害比5.61(2.11-14.71,95%CI),P<0.001)。结论:与无DM患者比较,DM患者有较高的多支血管病变发病率,高的MP负荷以及PR,预示有更高发生急性冠状动脉事件的可能性。Objective： To assess differences in morphology of coronary atherosclerotic plaque and vascular remodeling as detected by 520-rows coronary computed tomography angiography between patients with and without diabetes mellitus. Methods： We compared coronary atherosclerotic plaques and vascular remodeling between 252 diabetic patients and 487 non-diabetic patients who underwent 520-rows coronary computed tomography angiography （CCTA） for the evaluation of chest pain and coronary artery disease screening. Results： Patients with diabetes had a lower prevalence of single vessel lesion（x2=5.434, 〈 0.05）, a similar 2 vessels lesions（x2=0.912, P〈0.05）, and a higher prevalence of 5 （x2=4.887, P〈 0.05）and 4 vessels lesionsas compared to patients without diabetes. Segment-based single factor analysis showed that MP, obstructive plaque, and positive remodeling had a higher prevale with diabetes as compared without diabetes（x2=4.214, x2=4.415, x2=6.215; P 〈 0.05, respectively）. Segment-based Cox proportional hazards models analysis showed that only positive remodeling were positively correlated with diabetes（r=5.61, P〈 0.001）. Conclusion： Patients with diabetes have a higher prevalence of multiple vessels lesions, ME and positive remodeling as compared to patients without diabetes. It is possible that they have a higher morbidity of acute coronary events.

关 键 词：糖尿病 体层摄影术 X线计算机 冠心病 斑块 阳性重构 

分 类 号：R812[医药卫生—放射医学]