CT血管造影评估2型糖尿病及高血压下肢动脉斑块的对比研究  

Comparative study of lower extremity arterial plaque between type 2 diabetes mellitus and hypertension patients using CT angiography

作　　者：蒋宇婷 张帆 郭丹丹[1] 周广举[2] 李春平[1] 李睿[1] JIANG Yuting;ZHANG Fan;GUO Dandan;ZHOU Guangju;LI Chunping;LI Rui(Department of Radiology,the Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan Province 637000,China;Department of Endocrine,the Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan Province 637000,China)

机构地区：[1]川北医学院附属医院放射科,四川南充637000 [2]川北医学院附属医院内分泌科,四川南充637000

出　　处：《实用放射学杂志》2021年第10期1622-1625,1630,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目(81801674);四川省科技厅应用基础研究项目(2021YJ0242);南充市市校合作专项课题(19SXHZ0114).

摘　　要：目的探讨CT血管造影(CTA)评估2型糖尿病(T2DM)合并及未合并高血压患者下肢动脉血管斑块的差异.方法分析132例接受双下肢CTA检查患者,其中单纯T2DM(T2DM组)29例,单纯高血压(高血压组)40例,T2DM合并高血压(混合组)31例,血糖、血压正常(对照组)32例.对比组间双下肢血管斑块发生率、类型、形态、分布和累及血管狭窄程度的差异.结果T2DM组、高血压组、混合组及对照组分别检测出165段、250段、255段及103段动脉斑块.对照组和高血压组钙化斑块发生率较高,T2DM组和混合组混合斑块发生率明显高于高血压组(P<0.05).对照组斑块形态主要为Ⅰ型和Ⅱ型,T2DM组、高血压组及混合组以Ⅲ型斑块为主;高血压组及混合组Ⅳ型斑块发生率明显高于T2DM组.T2DM组以动脉轻中度狭窄为主,高血压组以动脉重度狭窄为主,而混合组以血管闭塞为主,且发生率高于T2DM组和高血压组(P<0.05).结论下肢CTA发现,T2DM患者下肢动脉易发生Ⅲ型混合斑块,管腔以轻中度狭窄为主;T2DM合并高血压,下肢动脉Ⅳ型混合斑块发生率明显增高,更易发生血管重度狭窄及闭塞.Objective To evaluate the difference of lower extremity arterial plaque in patients with type 2 diabetes mellitus(T2DM)with and without hypertension by CT angiography(CTA).Methods A total of 132 patients underwent CTA examination,including 29 patients with simple T2DM(T2DM group),40 patients with simple hypertension(hypertension group),31 patients with T2DM combined with hypertension(mixed group),and 32 patients with normal blood glucose and blood pressure(control group).The incidence,type,shape,distribution of plaque and the degree of vascular stenosis were compared between these groups.Results 165 segments,250 segments,255 segments and 103 segments of arterial plaques were detected in T2DM group,hypertension group,mixed group and control group respectively.The incidence of calcified plaque was higher in control group and hypertension group,and the incidence of mixed plaque in T2DM group and mixed group was significantly higher than that in hypertension group(P<0.05).The plaques in control group were mainly type Ⅰ and type Ⅱ,while the plaques in T2DM group,hypertension group and mixed group were mainly type DI;the incidence of type W plaques in hypertension group and mixed group was significantly higher than that in T2DM group.In T2DM group,mild to moderate arterial stenosis was the main reasonjin hypertension group,severe arterial stenosis was the main reason;in mixed group,vascular occlusion was the main reason,and the incidence was higher than that in T2DM group and hypertension group(P<0.05).Conclusion The lower extremity arterial plaques in T2DM patients are mainly mixed and type Ⅲ,accompanied by mild to moderate vascular stenosis observed by CTA.While T2DM patients associated with hypertension,the incidence of type Ⅳ mixed plaque is significantly increased,accompanied with severe vascular stenosis and occlusion increased.

关 键 词：2型糖尿病 高血压 下肢动脉 计算机体层成像 血管造影术 

分 类 号：R589.1[医药卫生—内分泌] R544.1[医药卫生—内科学]