新双源flash-CT评价老年冠心病合并2型糖尿病患者血管成像特点

目的探讨老年冠心病（CAD）合并2型糖尿病（T2DM）患者冠状动脉CT血管成像（CTA）的成像特点。方法入选2012年10月至2013年10月冠状动脉造影检查确诊为CAD的老年患者640例,其中合并T2DM者350例,无合并T2DM者290例,冠状动脉造影后2周内行新双源flash-CT冠脉成像,分析老年CAD合并T2DM患者冠状动脉CTA的诊断特点。结果新双源flash-CT冠状动脉CTA对T2DM合并CAD患者冠状动脉病变的诊断特异性为89.6%。CAD合并T2DM患者冠状动脉钙化较严重,病变支数多,随着钙化积分的增高,特异性有所下降,但CTA对于介入治疗仍有指导作用。结论新双源flash-CT冠状动脉CTA是诊断老年CAD合并T2DM患者冠状动脉病变可靠、无创的检查方法,但严重钙化者要结合冠脉造影结果进行综合判断。

Characteristics of coronary CTA in the elderly patients with coronary heart disease complicated with type 2 diabetes mellitus

Objective To explore the diagnostic characteristics of coronary CTA in the elderly patients with coronary heart diseases （CHD） complicated with type 2 diabetes mellitus（T2DM）. Methods A total of 640 cases diagnosed as CHD by coronary angiography （CAG） from Oct 2012 to Oct 2013 were enrolled in this study, among which 350 cases suf- fered from CHD complicated with T2DM and 290 cases without T2DM. Double source flash CT angiography was performed within a week after CAG detection and the diagnostic characteristics of CHD combined with T2DH were analyzed. Results The specificity of coronary CTA for the coronary vascular disorders in the patients with T2DM complicated with CHD was 89. 6%. The calcification of coronary arteries was more severe and the number of damaged branchs was more in the patients with CHD complicated with T2DM. With the increase of the score in calcification, the specificity decreased. Conclusions Coronary CTA is a reliable and non-invasive method for detecting the lesion of coronary arteries in the patients with CHD complicated with T2DM. But in case with severe calcified lesion, it should be diagnosed in combination with CAG.