糖尿病患者冠状动脉粥样硬化特征分析

Characteristics of coronary atherosclerosis in diabetes patients with mellitus CTA

①目的探讨糖尿病患者冠状动脉粥样硬化的临床特征。②方法选取2016年9月~2018年3月于我院行冠状动脉CT动脉造影(CTA)患者224例作为研究对象,根据是否伴有糖尿病,分为糖尿病组116例和非糖尿病组108例。观察两组冠状动脉粥样硬化的发生率、冠状动脉管腔狭窄程度以及各种性质斑块的发生情况。③结果糖尿病组冠状动脉粥样硬化发生率为96.6%,高于非糖尿病组(85.2%),差异有统计学意义(χ^2=10.085,P<0.05);糖尿病组冠状动脉无狭窄、轻中度狭窄及重度狭窄的发生率分别为3.4%、67.2%及29.4%,非糖尿病组分别为17.6%、61.1%及21.3%,两组冠状动脉管腔狭窄程度比较,差异有统计学意义(Z=-3.016,P<0.05);糖尿病组冠状动脉钙化斑块、混合斑块及软斑块的发生率分别为51.0%、31.3%及17.7%,非糖尿病组分别为65.8%、22.9%及11.2%,两组冠状动脉斑块性质比较,差异有统计学意义(χ^2=25.126,P<0.001)。④结论糖尿病患者冠状动脉粥样硬化发生率增加、冠状动脉狭窄程度加重、发生混合斑块和软斑块的可能性增加;CTA可以清晰显示,糖尿病患者冠状动脉血管斑块的位置、血管狭窄程度以及斑块的性质,为临床医师诊断和治疗提供影像学依据。

Objective To explore the impact of diabetes on the characteristics of coronary atherosclerosis.Methods A total of 116 diabetic patients who underwent coronary artery CTA examination were selected as diabetic group,and 108 non diabetics were selected as non-diabetic group.Coronary angiography was performed to observe the incidence of coronary atherosclerosis in two groups,the degree of coronary artery stenosis and the occurrence of various types of atherosclerotic plaques.Results The incidence of coronary atherosclerosis in the diabetic group and the non-diabetic group was 96.6% and 85.2% respectively.The difference between the two groups was statistically significant (χ^ 2=10.085, P < 0.05 ).The incidence of coronary artery stenosis,mild to moderate stenosis and severe stenosis in the diabetes group were 3.4%,67.2% and 29.4% respectively,and the coronary artery in the non-diabetic group,the incidence of coronary stenosis,mild to moderate stenosis,and severe stenosis in the non-diabetic group were 17.6%,61.1%,and 21.3%,respectively.The difference between the two groups was statistically significant (Z=-3.016, P < 0.05 ),indicating the difference in the degree of coronary artery stenosis between the two groups;the incidence of coronary artery calcified plaque, mixed plaque and soft plaque in the diabetic group was different.The rates were 51%,31.3% and 17.7% respectively.The incidence of coronary artery calcified plaque,mixed plaque and soft plaque in the non-diabetic group was 65.8%,22.9% and 11.2%,respectively.The two groups were statistically significant (χ^ 2=25.126, P < 0.001 ),indicating the two groups of coronary atherosclerosis in the two groups.The proportion of the form of the sclerosing plaques was different.Conclusion The incidence of coronary atherosclerosis in diabetic patients is increased,the degree of coronary artery stenosis is aggravated,and the possibility of unstable plaque,such as mixed plaque and soft plaque is increased.CTA can clearly show the location of coronary vasculaRplaque,the degree of vasculaRstenosis and the nature of plaque in diabetic patients,providing imaging evidence foRclinician diagnosis and treatment.