双源CT冠状动脉成像对2型糖尿病患者心血管事件的预测价值

The value of dual source computed tomography in predicting cardiovascular events in Type-2 diabetic patients

目的探讨双源CT冠状动脉成像对2型糖尿病患者心血管事件的预测价值。方法收集2011年1月-2013年6月93例接受双源CT冠状动脉成像检查的2型糖尿病患者,分析其冠状动脉钙化积分及CTA结果,对其随访至2014年12月31日,了解心血管事件发生情况。结果1）随访过程中,发生心血管事件组的钙化积分值高于非事件组,差异有统计学意义（t=2.950,P=0.015）。受试者工作特征（ROC）曲线分析,ROC曲线下面积为0.906,钙化积分值用于预测2型糖尿病患者发生心血管事件有显著意义（P=0.000）,选钙化积分=89（由约登指数确定）为诊断临界点,灵敏度为94.4%,特异度为80.0%,阴性预测值为100%;2）Spearman秩相关检验分析,冠状动脉CTA所示冠状动脉狭窄程度越重,心血管事件发生率越高（rs=0.528,P=0.000）。结论双源CT冠状动脉成像所得冠状动脉钙化积分及CTA结果能够为临床提供2型糖尿病患者心血管事件发生风险的信息,对患者的危险分层有一定价值。

Objective To explore the value of Dual Source CT in predicting cardiovascular events in type-2 diabetic patients. Methods Nighty-five consecutive type-2 diabetic patients undergoing CT with coronary artery calcium score and coronary angiography between January, 2011 to June, 2013 were prospectively enrolled in the study. Patients were followed up for the occurrence of cardiovascular events until December 31st, 2014. Results 1 ） Cardiovascular risk was lower in patiens with less calcium score （ t =2. 950, P =0. 015）. The area under ROC curve was 0. 906 （ P =0. 000）. Calcium score≥90 was predictor of cardiovascular events over time, with a high negative predictive value, and 94.4% sensitivity and 80.0% specificity; 2） By Spearman rank correlation analysis, the presence of plaque at the Dual Source CT was positively correlated with the incidence of cardiovascular events in type-2 diabetic patients. Conclusion Information including calcium score and plaques provided by Dual Source CT may help predict cardiovascular events in type-2 diabetic patients and may be useful for risk stratification of type-2 diabetic patients.