老年冠心病合并2型糖尿病患者320排螺旋CT冠状动脉血管成像特点

Clinical study of 320-multidetector computed tomography angiography for detecting coronary stenosis in elderly patientswith coronary artery disease combined with type 2 diabetes mellitus

目的:探讨老年冠心病合并糖尿病患者冠状动脉病变特点。方法:选择2009年7月至2013年10月,冠状动脉CT确诊为冠心病的老年(≥60岁)患者293例,其中合并2型糖尿病128例,未合并糖尿病165例,比较两组冠状动脉病变的特点及相关临床因素结果:两组间年龄、体质量质数(BMI)、吸烟、饮酒、平均病程、冠心病家族史、脑血管病及TG等,差异均无统计学意义(P>0.05);两组高血压患病率、TC及LDL-C差异有统计学意义。糖尿病组的冠状动脉CT主要表现为多支血管病变、弥散血管病变和左主干病变,分别占41%、24%和14%,显著多于非糖尿病组的24%、7%和8%(P<0.05)。糖尿病组的混合斑块及钙化斑块分别占66%和70%,显著多于非糖尿病组的18%和44%(P<0.05)。Logistic回归分析结果显示,年龄、性别、吸烟、冠心病家族史、TG及LDL-C是老年冠心病患者发生冠状动脉弥散性病变的独立危险因素(P<0.05)。结论:冠心病合并2型糖尿病患者混合斑块发生率较高,多支病变及弥散病变较多见。

Objective：To evaluate coronary lesions and plaque characteristics of elderly patients with coronary heart disease （CHD） complicated type 2 diabetes mellitus （DM） with 320 muhidetector computed tomography（MDCT） angiography of coronary. Methods：Select 293 elderly coronary artery disease cases from July 2009 to October 2013, and divide into 2 groups：Diabetic of 128 patients and non-diabetic of 165 patients groups. The results of coronary angiography and the risk factors were compared. Results： There was no statistically significant differences between two groups in age, BMI, smoking, drinking, mean disease duration, family history of coronary heart disease, cerebrovascular disease, TG （ P 〉 0. 05 ） ; The prevalence of hypertension, TC and LDL presented statistically significant difference （P 〈 0. 05 ）. Muhi-vessel disease, diffuse artery disease and left main disease for diabetic group account for 41%, 24% and 14% , significantly more than non-diabetic group of 24% , 7% and 8% （ P 〈 0. 05 ）. Mixed plaque and calcified plaque of diabetic group was 66% and 70%, significantly higher than non-diabetic group of 18% and 44% respectively （ P 〈 0. 05 ）. Logistic regression analysis showed that age, sex, smoking, family history of coronary heart disease, TG and LDL is an independent risk factor for coronary heart disease in elderly patients with diffuse coronary artery disease （ P 〈 0. 05）. Conclusion： Multi-vessel disease, diffuse artery disease Mixed plaque were more common in patients with CHD complicated type 2 diabetes mellitus.