糖尿病患者颈动脉粥样硬化斑块高分辨磁共振成像研究  

High-resolution MRI of carotid atherosclerotic plaques in diabetes mellitus patients

作　　者：马露[1] 崔豹[1] 曾源[2] 李依霞 韩旭[1] 蔡幼铨[1] 蔡剑鸣[3] 

机构地区：[1]解放军总医院放射诊断科,北京100853 [2]解放军306医院干部病房 [3]解放军总医院第一附属医院放射科

出　　处：《中华老年心脑血管病杂志》2015年第9期907-910,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金："十二五"全军科研计划面上项目(CWS11J065)

摘　　要：目的探讨糖尿病患者与糖代谢正常者颈动脉粥样硬化斑块的差异。方法选取糖尿病患者30例作为糖尿病组,糖代谢正常者28例作为糖代谢正常组,进行颈动脉3.0T MR高分辨扫描,依据MR图像,比较2组间斑块成分和颈动脉形态学指标的差异。结果糖尿病组颈动脉形成动脉粥样硬化斑块49支,糖代谢正常组47支,糖尿病组斑块内钙化(83.67%vs 55.32%,P=0.002)及薄/破裂纤维帽(67.35%vs 42.55%,P=0.015)的发生率明显高于糖代谢正常组;糖尿病组与糖代谢正常组斑块内出血(36.73%vs 44.68%,P=0.428)和富含脂质坏死核(85.71%vs 80.85%,P=0.523)比较,差异无统计学意义。糖尿病组在斑块最厚层面的管壁厚度高于糖代谢正常组,差异有统计学意义[(4.31±1.59)mmvs(4.01±1.62)mm,P=0.017];糖尿病组与糖代谢正常组血管总面积[(72.55±30.17)mm2 vs(81.54±34.15)mm2,P=0.432]和管壁标准化指数[(0.72±0.13)vs(0.66±0.15),P=0.255]比较,差异无统计学意义。结论糖尿病患者颈动脉动脉粥样硬化斑块的稳定性较糖代谢正常者差。Objective To study the carotid atherosclerotic plaques in diabetes mellitus （DM） pa- tients and normal glycometabolism subjects. Methods Thirty DM patients served as a DM group and 28 normal glycometabolism subjects served as a non-DM group in this study. Their carotid plaque compositions and carotid artery morphology were analyzed by scanning the carotid artery with high-resolution 3.0T MR. Results Atherosclerotic plaques were formed in 49 branches o{ coronary artery in DM group and 47 ranches of coronary artery in non-DM group. The incidence o{ calcified plaques and thin/ruptured fibrous caps was significantly higher in DM group than in non- DMgroup（83.67% vs 55.32%,P=0.002±67. 35% vs 42. 55%,P=0. 015）. The incidence of plaque bleeding was significantly lower in DM group than in non-DM group （36.73% vs 44.68%, P=0. 428）. No significant difference was found in IPH and LRNC between the two groups （P= 0. 523）. The maximum thickness of plaques was greater in DM group than in non-DM group （4.31±1.59 mm vs 4.01±1.62 mm,P=0. 017）. No significant difference was found in total vas- cular area and vascular wall standard index between DM group non DM group（72. 55 ± 30. 17 mm2vs81.54±34.15mm2,P=0. 432;0. 72＋0. 13vs0. 66±0. 15,P=0. 255）.Conclusion The stability of carotid atherosclerotic plaques is lower in DM patients than in normal glycometabolism subjects.

关 键 词：糖尿病 颈动脉疾病 动脉粥样硬化 磁共振成像 危险因素 

分 类 号：R587.2[医药卫生—内分泌] R543[医药卫生—内科学] R445.2[医药卫生—临床医学]