冠心病心绞痛合并糖尿病患者病变冠脉参照节段血管血管内超声的特点

目的：应用血管内超声成像（IVUs）评估冠心病心绞痛合并糖尿病患者冠脉造影示“正常”的病变冠脉参照节段的动脉粥样硬化病变大小，形态以及其与临床的相关性。方法：入选确诊心绞痛的患者82例，按是否合并DM分为：DM组（32例）和非DM组（50例）。应用IVUS对两组的84支参照节段血管进行检查。结果：所有82例84支血管参照节段血管内超声检测均存在动脉粥样硬化病变。与非DM组比较，DM组参照节段血管流通面积明显减小[（8．03±1．86）mm。比（7．79±1．27）mm2]，参照节段外弹力膜面积[（14．09±3．86）mm2比（15．29±2．51）mm2]、斑块负荷[（41．9±8．58）％比（48．69±6．86）％]、偏心指数[（3．76±2．49）比（8．13±6．77）]及病变长度[（6．66±4．73）mm比（10．58±5．74）mm]明显增大，P均〈0．01。直线相关：分析显示，参照节段斑块负荷与目标病变斑块负荷呈正相关（r=0．880，P〈0．001）。结论：在冠状动脉造影“正常”的参照节段同样存在动脉粥样硬化病变，且病变在糖尿病患者更加弥漫。

Intravascular ultrasound characteristics of reference segmental vessels for coronary artery with lesion in coronary artery disease patients with angina pectoris complicated diabetes mellitus

Objective： To evaluate size and form of atherosclerosis lesion in reference segments vessels （they were ＂normal＂ by angiography） for coronary artery with lesion in coronary artery disease patients with angina pectoris complicated diabetes mellitus （DM） using intravascular ultrasound imaging （IVUS） and its relationship with clinic. Methods： According to complicated with DM or not, a total of 82 patients with angina pectoris were selected and divided into DM group （n = 32） and non-DM group （n = 50）. IVUS was used to examine reference segments vessels in two groups. Results.. Atherosclerosis existed in all 84 reference segmental vessels of 82 cases was measured by IVUS. Compared with non-DM group, there were significant decrease in flow area of reference segments vessel [ （8. 03 ±1.86） mm2 vs. （7. 79 ± 1.27） mm2], and significant increase in external elastic membrane area [ （14.09 ± 3.86） mm2 vs. （15. 29±2.51） mm2], plaque burden [ （41.9±8. 58）% vs. （48. 69±6. 86）%], eccentricity index [ （3.76± 2.49） vs. （8. 13 ± 6.77）] and lesion length [ （6. 66 ± 4.73） mm vs. （10.58 ± 5.74） mm] of reference segments in DM group, P〈0.01 all. Linear correlation analysis indicated that plaque burden of reference segment vessel was positively correlated with plaque burden of target lesion （ r = 0. 880, P〈0. 001）. Conclusion. Atherosclerosis also exists in ＂normal＂ reference segment vessel by angiography and it＇s more diffuse in diabetic patients.