不同Fontaine分期糖尿病下肢动脉病变的CTA特点  

CTA characteristics of diabetic lower extremities arterial disease in different Fontaine stage

作　　者：何伟红[1] 方挺松[1] 柯祺[1] 杨延斌[2] 梁振华[1] 

机构地区：[1]广州中医药大学附属佛山中医院CT室,广东佛山528000 [2]广州中医药大学附属佛山中医院病案统计室,广东佛山528000

出　　处：《中国介入影像与治疗学》2017年第5期302-305,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：佛山市卫生和计生局医学科研课题(20160010);佛山市重点专科培育项目建设资助(Fspy3-2015019)

摘　　要：目的探讨不同临床Fontaine分期糖尿病下肢动脉病变的CTA特点。方法回顾性分析100例临床诊断为糖尿病下肢动脉病变,且接受双下肢动脉CTA患者的资料。根据临床表现对患者进行Fontaine分期。并对下肢动脉进行CTA分级。分析不同临床Fontaine分期患者下肢动脉的狭窄程度。结果不同临床Fontaine分期患者下肢动脉狭窄程度分级差异有统计学意义(χ~2=186.24,P<0.001)。膝上动脉、膝下动脉、足背及足底动脉不同Fontaine分期的狭窄程度分级差异有统计学意义(膝上动脉:χ~2=69.24,P<0.001;膝下动脉:χ~2=111.59,P<0.001;足背及足底动脉:χ~2=94.15,P<0.001)。膝上动脉与膝下动脉、足背及足底动脉狭窄程度分级差异有统计学意义(Z=12.59,P<0.001;Z=10.47;P<0.001)。膝下动脉与足背及足底动脉狭窄程度分级差异有统计学意义(Z=12.66,P<0.001)。膝下动脉闭塞常伴侧支血管生成。结论 CTA诊断结果能准确反映下肢动脉临床分期,是诊断糖尿病下肢动脉的理想检查方法。Objective To explore CTA characteristics of diabetic lower extremities arterial disease （LEAD） with different Fontaine stage. Methods Data of 100 patients clinically diagnosed as diabetic LEAD and underwent lower limbs arterial CTA were analyzed retrospectively. The patients were classified into grade Ⅰ-Ⅳ according to Fontaine classifications. Lower extremities arteries were graded according to CTA. Stenosis degree of lower extremity arteries in different Fontaine stages were analyzed. Results The grades of lower extremity arteries stenosis in different Fontaine stages had statistically significant difference （χ2=186.24,P〈0.001）. There had statistically significant difference of stenosis degree in different lower extremity arterial levels among different Fontaine stages （superior genicular artery： χ2=69.24, P〈0.001; inferior genicular artery： χ2=111.59, P〈0.001; dorsalis pedis and arteriae plantaris： χ2=94.15, P〈0.001）. Grades of stenosis between superior genicular arteries and inferior genicular arteries, superior genicular arteries and dorsalis pedis and arteriae plantaris had statistically significant differences （Z=12.59, P〈0.001; Z=10.47, P〈0.001）. There was statistically significant difference of stenosis grades between inferior genicular artery and dorsalis pedis and arteriae plantaris （Z=12.66, P〈0.001）. Occluded inferior genicular arteries usually associated with collateral vessels. Conclusion CTA can reflect the clinical stages of LEAD, which is the ideal method in diagnosing of diabetic LEAD.

关 键 词：糖尿病并发症 下肢 动脉 体层摄影术 X线计算机 血管造影术 

分 类 号：R587.2[医药卫生—内分泌]