不同年龄段糖尿病患者冠状动脉CT血管造影特征：1876例分析

Angiographic characteristics of coronary artery in diabetic patients at different age： analysis of 1876 cases

目的探讨不同年龄段糖尿病患者冠状动脉cT血管造影（coronarycomputedtomographyangiography,CCTA）血管特征及糖尿病患者CCTA的检查时机。方法回顾分析了1876例临床怀疑冠心病而行CCTA检查的糖尿病患者的冠状动脉特征。将研究对象按年龄段分为〈60岁组和≥60岁组，进一步按照有否高血压、血脂异常、肥胖和吸烟等因素分层，比较了两组患者的冠状动脉狭窄和钙化积分差异。结果≥60岁组糖尿病患者血管狭窄发生率（32．11％）较〈60岁组（24．39％）显著增高（P〈0．05），多支血管病变发生率≥60岁组（23．25％）显著高于〈60岁组（14．0I％，P〈0．05）无论合并肥胖、吸烟、血脂异常与否，与〈60岁组相比，≥60岁组中有更高比例的患者合并重度冠脉狭窄和／或中度狭窄、更多支的冠脉病变和更严重的钙化积分，两组差异有统计学意义（P〈0．05o结论对于60岁以上合并多种危险因素的糖尿病患者，宜尽早行冠心病的筛查。CCTA可提供简便、无创的检查手段。

Objective To determine the CT angiographic characteristics of coronary artery of diabetic patients in different age groups and to discuss the appropriate time for them to undergo coronary computed tomography angiography（CCTA）. Methods A retrospective analysis was performed on the coronary CT angiographic characteristics of 1876 diabetic patients suspected of coronary heart disease （CHD）. These patients were divided into 〈 60 years group （878 cases） ands〉 60 years group（998 cases）. The coronary stenosis and calcification score were compared between the two age groups after stratification by hypertension, dyslipidemia, obesity and smoking. Results There were significant differences between the two groups in the prevalence of coronary stenosis （32.11% vs 24.39%, P 〈 0.05） and the prevalence of multivessel lesions （23.25% vs 14.01%, P 〈 0.05）. After stratification by obesity, smoking, and dyslipidemia, the statistical analysis showed that there were more patients who had severe or/and moderate coronary stenosis, multi-vessel lesions and higher calcium score in≥60 years group than in 〈 60 years group（P 〈 0.05）. Conclusions For diabetic patients with multiple coronary risk factors and aged≥60 years, early screening for coronary artery disease is recommended. CCTA is a simple and noninvasive method for this task.