2型糖尿病伴或不伴有糖尿病足患者冠状动脉造影影像差异分析

Discuss the coronary CT angiography imaging difference of type 2 diabetes mellitus with or without diabetic foot

目的比较2型糖尿病伴有糖尿病足与2型糖尿病不伴有糖尿病足患者冠状动脉CT造影（CTA）的影像差异。方法连续收集2013年10月至2015年6月间临床怀疑冠心病的2型糖尿病患者60例,其中2型糖尿病伴有糖尿病足（DF）患者30例,2型糖尿病不伴有糖尿病足（DM）患者30例,进行冠状动脉CTA后,统计2组患者冠状动脉的钙化积分、冠状动脉斑块性质、冠状动脉斑块分布、冠状动脉被累及的支数以及冠状动脉管腔的狭窄程度,并进行χ^2检验。结果在所收集的60例2型糖尿病患者中,DF与DM组患者冠状动脉钙化总积分（Agatston积分）为23 716与10 749,冠状动脉钙化平均积分790.5与358.3。冠状动脉斑块分布、冠状动脉斑块所致血管狭窄以及斑块累及冠状动脉支数,2组差异无统计学意义。在DF组与DM组中,硬化斑块、混合斑块及软斑块分别为：6∶11;9∶1;11∶9,2组差异具有统计学意义（χ2=7.625,P=0.022）;DF组中尤以不稳定斑块为主（χ2=4.321,P=0.038）,并且2组冠状动脉狭窄中,DF组冠状动脉中重度狭窄明显严重,且具有统计学差异（χ2=4.309,P=0.038）。结论 DF患者与DM患者在冠状动脉CTA中,DF患者在冠状动脉不稳定斑块、中重度狭窄方面具有较大差异。

Objective To discuss the coronary CT angiography imaging difference between diabetes meUitus with diabetic foot（DF） group and diabetes mellitus without diabetic foot（DM） group. Mathods Thirty DF patients and 30 DM patients were rolled and underwent 64-detector row CT from Oct 2013 to Jun 2015. By multidetector CT coro- nary angiograms coronary artery calcium,plaque composition, plaque distribution,number vessels involved and lumi- nal stenosis were retrospectively analyzed and classified. The Chi-square test was used to analyze the data. Results The total agatston score was 23 716 vs 10 749 and the average agatston score was 790.5 vs 358.3 in DF group and DM group. There is significant difference in DF group in plaque composition （P=0.022）, especially in vulnerable plaque in DF group（χ2=4.321, P=0.038）.The same result occurred in mild to moderate and severe luminal stenosis（χ2=- 4.309, P=0.038）. But there is no significant difference in coronary artery calcium, plaque distribution,number vessels involved and luminal stenosis（P〉0.05）. Conclusion There is significant difference in DF group in plaque composi- tion,moderate and severe luminal stenosis.