肝/脾CT值比与糖尿病合并动脉硬化斑块的关系研究  

Study on the Relationship between Liver/Spleen CT Ratio and Diabetic Arteriosclerotic Plaque

作　　者：石文达[1] 张丹[1] 崔志新[1] 李桂萍[1] 王国玉[2] 赵晓彬 肖旭[3] SHI Wenda;ZHANG Dan;CUI Zhixin(Affiliated Hospital of Chengde Medical College,Chengde,Hebei Province 067000,P.R.China)

机构地区：[1]河北承德医学院附属医院(南院区放射科),067000 [2]河北承德医学院附属医院老年病科,067000 [3]河北承德医学院附属医院临床药学部,067000

出　　处：《临床放射学杂志》2021年第7期1340-1345,共6页Journal of Clinical Radiology

基　　金：承德市科技局科技支撑计划项目(编号:201801A044)。

摘　　要：目的探究肝/脾CT值比与糖尿病合并动脉硬化斑块的关系。方法搜集2015年9月至2020年4月临床怀疑动脉硬化行冠状动脉、双下肢动脉或主动脉CT血管成像(CTA)且符合纳入、排除标准的糖尿病患者113例,根据CTA检查结果分为动脉硬化斑块阳性(病例组)与动脉硬化斑块阴性(对照组)。比较两组一般资料、肝和脾CT值、肝/脾CT值比,采用Pearson分析肝和脾CT值、肝/脾CT值比与糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、脂肪细胞浸润程度相关性,采用Logistic回归方程分析糖尿病合并动脉硬化斑块的相关影响因素,采用受试者工作特征曲线(ROC)及曲线下面积(AUC)分析肝和脾CT值、肝/脾CT值比评估糖尿病合并动脉硬化斑块效能。结果病例组非酒精性脂肪性肝病(NAFLD)、高脂血症、高血压占比、HbA1c、HOMA-IR高于对照组,肝CT值、肝/脾CT值比低于对照组(P<0.05);肝CT值、肝/脾CT值比均与HbA1c、HOMA-IR、脂肪细胞浸润程度呈负相关(P<0.05);糖尿病患者发生动脉硬化斑块与NAFLD、高脂血症、高血压、HbA1c、HOMA-IR、肝CT值、肝/脾CT值比显著相关(P<0.05);肝CT值、肝/脾CT值比在评估糖尿病合并动脉硬化斑块方面均具有良好价值,其中肝/脾CT值比评估的AUC最大,为0.810,截断值评估敏感度为86.54%,特异度为70.49%;有无低密度斑块患者肝CT值、肝/脾CT值比对比,差异具有统计学意义(P<0.05)。结论肝/脾CT值比降低是糖尿病合并动脉硬化斑块的主要影响因素之一,且与患者HbA1c、HOMA-IR、脂肪细胞浸润程度呈负相关,早期明确肝/脾CT值比,可辅助临床评估糖尿病合并动脉硬化斑块发生风险。Objective To explore the relationship between the ratio of liver/spleen CT value and diabetes mellitus with atherosclerotic plaque.Methods From September 2015 to April 2020,113 diabetic patients with suspected arteriosclerosis underwent coronary CT angiography(CTA),lower limb arterial CTA or aortic CTA and met the inclusion and exclusion criteriain our hospital were retrospectively selected.According to the examination results,they were divided into a case group(positive atherosclerotic plaque,n=52)and a control group(negative atherosclerotic plaque,n=61).The general data,liver and spleen CT value,liver/spleen CT value ratio were compared between the two groups.Pearson was used to analyze the correlation between liver and spleen CT value,liver/spleen CT value ratio and glycosylated hemoglobin(HbA1 C),insulin resistance index(HOMA-IR),and degree of fat cell infiltration.Logistic regression equation was used to analyze the related influencing factors of diabetes and atherosclerotic plaque.The receiver operating characteristic curve(ROC)and area under the curve(AUC)were used to analyze the CT values of liver and spleen,and the ratio of CT values of liver/spleen to evaluate the efficacy of diabetes and atherosclerotic plaque.Results The proportion of non-alcoholic fatty liver disease(NAFLD),hyperlipidemia,hypertension,HbA1 C,and HOMA-IR in the case group were higher than those in the control group,and the liver CT value and liver/spleen CT value ratio were lower than those in the control group(P<0.05);the liver CT value and the liver/spleen CT value ratio were negatively correlated with HbA1 C,HOMA-IR,and the degree of fat cell infiltration(P<0.05);the occurrence of atherosclerotic plaque in diabetic patients was significantly correlated with NAFLD,hyperlipidemia,hypertension,HbA1 C,HOMA-IR,liver CT value,liver/spleen CT value ratio(P<0.05);the liver CT value and the liver/spleen CT value ratio had good value in the evaluation of diabetes complicated with atherosclerotic plaque.Among these,the AUC value evaluated by

关 键 词：糖尿病 动脉硬化斑块 肝/脾CT值比 非酒精性脂肪性肝病 关联性 

分 类 号：R587.2[医药卫生—内分泌] R543.5[医药卫生—内科学]