双源CT评估糖尿病与冠脉斑块相关性的价值研究

目的：利用双源CT（DSCT）血管成像技术探讨糖尿病与冠状动脉粥样硬化斑块形成之间的相关性。材料与方法：收集本院2013年4月到2014年8月接受DSCT冠状动脉造影检查的病例,以调查问卷作为分组依据,筛选出糖尿病组（n=300）和非糖尿病组（对照组n=300）,其中糖尿病组根据病程的长短又分为2组：1组,糖尿病病程≤5年,共180例;2组,病程〉5年共120例。观察并比较两组患者斑块的发生率、分布特点、狭窄程度及斑块类型。结果：病变累及血管支数及范围比较。糖尿病组冠脉3支血管病变发生率为27.5%,非糖尿病组为20.6%;糖尿病组弥漫性病变发生率为43.8%,非糖尿病组为17.4%,两组比较差异均有统计学意义（P〈0.05）。狭窄程度比较：糖尿病组重度狭窄、完全闭塞的比例分别为7.9%、4.8%;非糖尿病组分别为3.7%、1.9%,糖尿病组狭窄程度较非糖尿病组增高,两组比较差异有统计学意义（P〈0.05）。糖尿病2组重度狭窄、完全闭塞的比例分别为12.2%、7.8%,1组分别为0.93%、0%,两组之间差异有统计学意义（P〈0.05）。斑块性质比较：糖尿病组混合斑块的发生率为51.4%,非糖尿病组为38.9%,而非钙化斑块的发生率,糖尿病组为43.8%,非糖尿病组为53.7%,两组比较差异均有统计学意义（P〈0.05）;糖尿病2组混合斑块的发生率为63.3%,1组为31.5%,两组比较差异亦有统计学意义。结论：DSCT冠状动脉造影能够准确评价糖尿病与冠脉斑块之间的关系。糖尿病患者冠脉斑块累及范围更广、管腔狭窄更严重、混合斑块发生率更高,并处于更易发生心血管事件的高危状态,随着病程的延长而加剧。

Study on the Value of Dual Source CT Assessment of Correlation between Diabetes and Coronary Plaque

Objective： To investigate the correlation between diabetes and the formation of coronary atherosclerotic plaque in DSCT angiography. Methods： The patients underwent DSCT coronary angiography, on the basis of questionnaires, were divided into diabetes group（n = 300） and non-diabetes group（n = 300） first, then diabetes group, which was divided into two groups：group 1,duration of diabetes less than or equal to 5 years（n = 180） and group 2,duration of diabetes more than 5 years（n = 120）. Two groups were observed and compared the incidence rate of plaque, distribution characteristics and types. Results： The incidence rate of 3 coronary artery vascular lesions was 27.5% in diabetes group and 20.6.0% in non diabetes group. Incidence rate of diffuse lesions was 43.8% in diabetes group, 17.4% in non diabetes group, the difference between the two groups were statistically significant（P 〈 0.05）. Comparison of the degree of coronary artery stenosis： Severe stenosis was 7.9% and occlusion was 4.8% in diabetes group; those were 3.7% and 1.9% respectively in non diabetes. Severe stenosis was 12.2% and occlusion was 7.8% in group 2; those were 0.93%, 0% in group 1, the difference between the two groups were statistically significant（P 〈 0.05）. Plaque types： occurrence rate of mixed plaque was 51.4% in diabetes group and 38.9% in non diabetes group. The incidence of non calcified plaque was 43.8% in diabetes group, 53.7% in non-diabetes group, the difference between the two groups were statistically significant（P 〈 0.05）. occurrence rate of mixed plaque was 63.3% in group 2 and 31.5% in group 1,The difference between the two groups were statistically significant（P 〈 0.05）. that both diabetes and duration of diabetes were independent risk factor for mixed plaque. Mixed plaque was increased with the duration of diabetes increasing through statistical analysis. Conclusion： DSCTCA can evaluate the relationship between the diabetes and coronary artery plaque. Coronary plaque involv