64排CT冠状动脉成像评估糖尿病患者斑块量化特征

Value of quantification of coronary artery lesion in patients with diabetes using cardiac computed tomographic angiography

目的 :探讨糖尿病和无糖尿病冠心病患者64排CT冠状动脉成像(CCTA)斑块量化特征的区别。方法:拟诊冠心病行64排CCTA检查且证实有斑块者315例,比较糖尿病组103例和非糖尿病组212例的冠状动脉粥样硬化斑块的最大横截面积、体积、斑块负荷、重构指数和厚度长度比及CT值。结果:糖尿病组体质量指数高于非糖尿病组(P<0.05)。2组年龄、性别、吸烟情况、血压、血脂情况均无明显差异。糖尿病组斑块的最大横截面积(平均6.22 mm2)、体积(平均25.34 mm3)、斑块负荷(平均48.55%)、重构指数(平均1.37)、厚度长度比(平均0.37)、钙化斑块比例(38.57%)、混合斑块比例(34.29%)均显著高于非糖尿病组(分别为4.81 mm2、12.60 mm3、32.43%、1.11、0.23、28.34%、23.53%),非钙化斑块比例(27.14%)低于非糖尿病组(48.13%)(均P<0.05)。结论:64排CT能够有效测量斑块,糖尿病患者的斑块体积、面积、斑块负荷、重构指数、厚度长度比均显著大于非糖尿病患者。与非糖尿病者相比,糖尿病组钙化斑块及混合性斑块比例更高,非钙化斑块比例较低。

Objective：To explore the difference of quantification of coronary artery plaques between patients with and without diabetes mellitus using cardiac computed tomographic angiography（CCTA）. Methods：A total of 315 patients including 103 with diabetes and 212 controls who underwent 64-slice CCTA and confirmed to have coronary plaques were studied. Plaque area, plaque volume,plaque burden,remodeling,ratio of thickness and length and CT value of plaques was compared between the two groups. Results：Body mass index was higher in diabetes group. There were no difference for age ,gender,smoking,blood pressure and blood lipid between two groups. Diabetes group had higher plaque area （median ：6.22mm2 vs.4.81mm2） ,plaque volume （25.34mm3 vs.12.60mm3）,plaque burden （48.55% vs.32.43%）,remodeling index （1.37 vs.l.ll）,ratio of thickness and length （0.37 vs.0.23） ,calcium plaque ratio （38.57% vs.28.34%）,mixed plaque ratio （34.29% vs.23.53%） and lower noncaleified plaque ratio （27.14% vs.48.13%）. Conclusion：Plaque area,plaque volume,plaque burden,remodeling and ratio of thickness and length measured on 64-slice CCTA is higher in diabetes patients than those in patients without diabetes. Compared with patients without diabetes,the calcium plaque ratio and mixed plaque ratio is higher while nonealcified plaque ratio is lower in patients with diabetes.