64层螺旋CT在冠心病合并2型糖尿病诊断中的应用

目的:评价64层螺旋CT冠状动脉造影检测冠心病合并2型糖尿病患者冠脉病变程度、冠脉内斑块性质的价值及其局限性.方法:对经选择性冠状动脉造影证实为冠心病的52例患者(糖尿病组24例,非糖尿病组28例)进行64层螺旋CT冠状动脉成像,对主要冠状动脉狭窄程度及斑块性质进行评价.结果:糖尿病组血管病变支数明显多于非糖尿病组(P<0.01),糖尿病组单支病变明显少于非糖尿病组(P<0.05),糖尿病组三支病变发生率为50.0%,而非糖尿病组发生率为21.4%,两组比较差异有统计学意义(P<0.05).糖尿病组弥漫性病变明显多于非糖尿病组(P<0.01),重度狭窄病变明显多于非糖尿病组(P<0.05).两组患者冠脉内共检测到130个斑块,两组之间的斑块数目差别无统计学意义;糖尿病组以软斑块为主,钙化斑块次之,非糖尿病组以钙化斑块和混合斑块为主,两者比较差异有统计学意义(P<0.01).结论:64层螺旋CT冠脉成像可有效检测冠心病合并2型糖尿病患者冠脉病变程度和冠脉斑块性质,对冠心病诊断和临床评估冠心病风险具有一定价值.

Applications of 64-slice spiral computed tomography in paitents with coronary heart disease accompanied with type-2 diabetes mellitus

Objective: To evaluate the applications of 64-slice spiral computed tomography in detecting the features of coronary arteriographies and the plaque character in patients with coronary heart disease(CHD)accompanied with type-2 diabetes mellitus(DM).Methods: Fifty two patients with CHD were confirmed by coronary angiography(CAG) and divided into DM(n=18)and NonDM(n=34)groups based on diabetes mellitus.All the patients underwent 64-slice spiral CT coronary angiography to detect the stenosis degree and atherosclerosis plaque character in main coronary artery. Results: DM group had a higher prevalence of the culprit lesion,a higher prevalence of three-vessel disease and a lower prevalence of single-vessel disease than those in NonDM group.The number of plaques had no difference between two groups,however,soft plaque in the DM group were more than those in the NonDM group(P<0.01). Conclusion: Sixty four-slice spiral CT can sufficiently detect the features of coronary arteriographies and the plaque character in paitents with CHD accompanied with type-2 DM and t can also be used to evaluate the stability of coronary plaques.