MSCTA诊断糖尿病足溃疡下肢动脉疾病的临床应用价值  

The clinical value of MSCTA in diagnosing lower extremity arterial disease of diabetic foot ulcers

作　　者：何伟红[1] 方挺松[1] 柯祺[1] 杨延斌[2] 肖秀云[1] 

机构地区：[1]佛山市中医院CT室,广东佛山528000 [2]佛山市中医院病案统计室,广东佛山528000

出　　处：《实用放射学杂志》2017年第7期1077-1079,1087,共4页Journal of Practical Radiology

基　　金：佛山市卫计局立项课题（20160010）;佛山市重点专科培育项目建设资助（Fspy3-2015019）.

摘　　要：目的 探讨多层螺旋CT血管造影（MSCTA）诊断和评估糖尿病足溃疡下肢动脉疾病（LEAD）的临床应用价值及糖尿病足溃疡可能的影响因素.方法 对80例糖尿病患者进行MSCTA检查,以是否并发足溃疡分组,分别计算胫动脉钙化积分（TACS）、外周动脉闭塞指数（PAOI）,并分析糖尿病足溃疡可能的危险因素.结果 足溃疡30例,出现下肢动脉闭塞18例,平均PAOI为4.40（3.60,5.75）,非足溃疡50例,出现下肢动脉闭塞8例,平均PAOI为2.05（1.43,3.10）.老年人、有吸烟史及体质量指数（BMI）较低的糖尿病患者易发足溃疡.他们常具有更高的TACS及出现更严重的外周动脉闭塞性疾病.多元逐步回归模型显示糖尿病足溃疡与TACS及PAOI显著相关,偏相关分析显示TACS对糖尿病足溃疡的影响不依赖PAOI.结论 MSCTA对诊断及评估糖尿病足溃疡LEAD具有重要临床应用价值.年龄、吸烟史、BMI、TACS及PAOI都会影响糖尿病足溃疡的发病,TACS及PAOI是糖尿病足溃疡的独立危险因素.Objective To study the value of MSCT angiography（MSCTA）in diagnosing lower extremities arterial disease （LEAD） of diabetic foot ulcers and analyze the possible influential factors on the onset of diabetic foot ulcers.Methods 80 diabetic patients for MSCTA examination were divided into two groups by whether combined with foot ulcers.The tibial artery calcification score （TACS） and peripheral arterial occlusion index （PAOI） were calculated and the possible risk factors of diabetic foot ulcer were analyzed.Results There were 30 cases suffered with foot ulcer and 18 cases occurred lower extremity arterial occlusion （LEAO）, the average PAOI was 4.40（3.60, 5.75）.Non-foot ulcer cases were 50, and there were 8 cases suffered with LEAO, the average PAOI was 2.05（1.43, 3.10）.Compared to patients without foot ulcer, patients with foot ulcer were older, had a lower BMI, and were more likely to have a history of tobacco use.They usually had higher TACS and severer peripheral arterial occlusive disease （PAOD）.Stepwise regression model showed that foot ulcers had significant correlation with TACS and PAOI.Partial correlation analysis showed TACS was independent from PAOI in impacting diabetic foot ulcer.Conclusion MSCTA has important clinical value in diagnosing and valuing diabetic foot ulcer LEAD.Age, smoking history,BMI,TACS and PAOI affect the incidence of diabetic foot ulcers, and TACS and PAOI are the independent risk factors for diabetic foot ulcers.

关 键 词：糖尿病 足部溃疡 计算机体层成像 血管造影术 

分 类 号：R587.1[医药卫生—内分泌] R814.42[医药卫生—内科学]