320排CT在糖尿病冠状动脉粥样硬化斑块形态学及管腔重构的研究 |
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引用本文: | 董莘 秦崇 时文伟等. 320排CT在糖尿病冠状动脉粥样硬化斑块形态学及管腔重构的研究[J]. 中国医学装备, 2014, 0(3): 62-66 |
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作者姓名: | 董莘 秦崇 时文伟等 |
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作者单位: | 解放军第309医院放射科,北京100091 |
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摘 要: | 目的:评估糖尿病(DM)和无DM患者320排冠状动脉CT造影(ccTA)冠状动脉粥样硬化斑块形态学及管腔重构的不同。方法:比较由于胸痛和冠心病的筛查而接受320排CCTA检查的232例DM患者和487例无DM患者的冠状动脉粥样硬化斑块形态学及管腔重构。结果:DM患者与无DM患者相比较,DM患者单支血管病变发生率低(X2=5.434,P〈0.05);2支血管病变发病率相似(X2=0.912,P〉0.05);而3、4支血管病变发病率高(X2=4.887,P〈0.05);单因素分析显示,DM组混合性斑块、梗阻性斑块以及阳性重构(PR)发病率高(X2=4.214,X2=4.415,X2=6.215;P〈0.05),而多因素Cox比例风险回归模型分析显示,仅PR与DM呈正相关(危害比5.61(2.11-14.71,95%CI),P〈0.001)。结论:与无DM患者比较,DM患者有较高的多支血管病变发病率,高的MP负荷以及PR,预示有更高发生急性冠状动脉事件的可能性。
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关 键 词: | 糖尿病 体层摄影术 X线计算机 冠心病 斑块 阳性重构 |
Assessment on 320-rows coronary computed tomography angiography differences in morphology of coronary atherosclerotic plaques and vascular remodeling in diabetes and non-diabetes |
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Affiliation: | DONG Xin, QIN Chong, SHI Wen-wei, et al Department of Radiology, the-309th Hospital of PLA, Beijing 100091, China. |
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Abstract: | Objective: To assess differences in morphology of coronary atherosclerotic plaque and vascular remodeling as detected by 520-rows coronary computed tomography angiography between patients with and without diabetes mellitus. Methods: We compared coronary atherosclerotic plaques and vascular remodeling between 252 diabetic patients and 487 non-diabetic patients who underwent 520-rows coronary computed tomography angiography (CCTA) for the evaluation of chest pain and coronary artery disease screening. Results: Patients with diabetes had a lower prevalence of single vessel lesion(x2=5.434, 〈 0.05), a similar 2 vessels lesions(x2=0.912, P〈0.05), and a higher prevalence of 5 (x2=4.887, P〈 0.05)and 4 vessels lesionsas compared to patients without diabetes. Segment-based single factor analysis showed that MP, obstructive plaque, and positive remodeling had a higher prevale with diabetes as compared without diabetes(x2=4.214, x2=4.415, x2=6.215; P 〈 0.05, respectively). Segment-based Cox proportional hazards models analysis showed that only positive remodeling were positively correlated with diabetes(r=5.61, P〈 0.001). Conclusion: Patients with diabetes have a higher prevalence of multiple vessels lesions, ME and positive remodeling as compared to patients without diabetes. It is possible that they have a higher morbidity of acute coronary events. |
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Keywords: | Diabetes mellitus Tomography, X-ray computed Coronary artery disease Plaque Positive remodeling |
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