高血压与糖尿病患者冠状动脉CT血管成像及钙化积分特征

Different Characteristics of Coronary Computed Tomographic Angiography and Coronary Artery Calcium Score in Patients with Hypertension or Diabetes Mellitus

目的探讨高血压和糖尿病患者冠状动脉CT血管成像(coronary computed tomographic angiography,CCTA)与冠状动脉钙化积分(coronary artery calcium score, CACS)的不同特点.方法回顾攀枝花市中心医院行CCTA的患者243名,其中无糖尿病及高血压患者78名(N组),高血压患者115名(HT组),糖尿病患者50名(DM组),分析3组患者CCTA冠状动脉病变情况并计算CACS.结果阻塞性病变患者比例DM组最高(34%),HT组次之(18.2%),N组最低(7.8%),P<0.05;DM组患者冠状动脉病变累及段积分(segment involvement score,SIS)高于HT组和N组(P<0.05);N组、HT组和DM组患者CACS中位数依次升高(分别为7.7、67.2和148.3,P<0.01).结论高血压和糖尿病患者发生冠状动脉病变的风险以及病变的程度和范围增加,冠状动脉钙化积分也更高;糖尿病患者较高血压患者上述改变更为显著.

Objective To explore the characteristics of coronary computed tomographic angiography（CCTA）and coronary artery calcium score（CACS） in patients with hypertension or diabetes mellitus.Methods Data of243 patients undergone CCTA in our hospital were retrospectively reviewed. Of these patients,78 were free of hypertension and diabetes mellitus（N group）, 115 with hypertension（HT group）, and 50 with diabetes mellitus（DM group）. Coronary artery disease（CAD） severity, extent and CACS were evaluated. Results Obstructive lesions were most frequent in patients in DM group, followed by those in group HT and N（34%,18.2% and 7.8%, respectively,P〈0.05）. Segment involvement score（SIS） of patients with DM was higher than that in group HT and DL（P〈0.05）. The median calcium score of patients increased 7.7 in N group,67.2 in HT,and 148.3 in DM with significant difference（P〈0.05）. Conclusion The prevalence, severity and extent of CAD, as well as CACS are worse in patients with hypertension and diabetes mellitus, especially in patients with diabetes mellitus.