糖尿病患者冠状动脉粥样硬化的CTA特征分析

Analysis of CTA Characterisation of Coronary Atherosclerosis with Diabetes Mellitus

目的:利用双源CT冠脉成像(DSCTA)分析合并糖尿病的冠状动脉粥样硬化患者冠脉斑块类型、分布及狭窄程度的关系。方法:98例行DSCTA检查的冠心病患者,其中50例合并糖尿病、48例非糖尿病,分析其冠状动脉粥样硬化斑块类型、分布、狭窄程度及主要临床表现的特点。结果:糖尿病与非糖尿病患者冠脉动脉粥样硬化病变分布及斑块类型具有统计学意义(X^2=7.01,P=0.03;X^2=6.75,P=0.03);而冠脉狭窄程度及急性冠脉综合征、高血压、高血脂发生率差异无统计学意义(X^2=1.86,P=0.60;X^2=0.43,P=0.84;X^2=0.52,P=0.47;X^2=0.12,P=0.73);糖尿病患者HbA1c≥6.5%为切点,临床并发症的发生率具有统计学意义(X^2=8.79,P=0.003)。结论:糖尿病患者冠状动脉粥样硬化更容易出现钙化及混合斑块,双支及多支病变的发生率较非糖尿病组明显增加;糖尿病患者HbA1c≥6.5%时容易发生临床并发症。

Objective:To analyze the relationship between diabetes mellitus and coronary atherosclerotic plaque type,distribution and stenosis degree by dual-source CT coronary angiography(DSCTA).Methods:98 patients underwent coronary CTA examination with coronary heart disease(CHD),including 50 patients with diabetes mellitus and 48 patients without diabetes mellitus.The types,distribution,stenosis degree and main clinical manifestations of coronary atherosclerotic plaques were analyzed.Result:The distribution of coronary atherosclerotic lesions and plaque types in diabetic and non-diabetic patients had statistical significance(c2=7.01,P=0.03;c2=6.75,P=0.03).There was no significant difference in the incidence of degree and acute coronary syndrome,hypertension and hyperlipidemia(c2=1.86,P=0.60;c2=0.43,P=0.84;c2=0.52,P=0.47,c2=0.12,P=0.73).With the cut-off point of HbA1c≥6.5%in diabetic patients,the incidence of clinical complications was statistically significant(c2=8.79,P=0.003).Conclusion:Coronary atherosclerosis in diabetic patients is more prone to calcification and mixed plaque.The incidence of double-vessel and multi-vessel lesions is significantly increased in diabetic patients.Diabetic patients are prone to clinical complications when HbA1c≥6.5%.