冠脉CT血管造影诊断2型糖尿病患者冠脉病变的应用价值

Application value of coronary CT angiography in diagnosis of coronary lesions in patients with type 2 diabetes mellitus

目的探讨冠脉CT血管造影(CCTA)技术在2型糖尿病患者冠脉病变筛查诊断中的应用价值。方法收集35例2型糖尿病患者共189个冠脉节段的CCTA和冠状动脉造影(CAG)检查结果。以CAG为冠脉病变诊断的"金标准",分析CCTA对2型糖尿病患者冠脉病变的诊断价值。结果CCTA诊断2型糖尿病患者冠脉狭窄的灵敏度为75.86%,特异度为73.53%,阳性预测值为70.97%,阴性预测值为78.13%,CCTA与CAG对2型糖尿病患者冠脉狭窄程度的诊断一致性一般(Kappa值=0.491,P<0.05)。结论CCTA对2型糖尿病患者冠脉病变的筛查具有较高的灵敏度和特异度,但其与CAG对冠脉狭窄程度的诊断一致性一般,或可作为临床筛查2型糖尿病患者冠脉病变的无创检查方法。

Objective To explore the application value of coronary CT angiography(CCTA)technology in the screening and diagnosis of coronary lesions in patients with type 2 diabetes mellitus(T2DM).Methods The findings of CCTA and coronary angiography(CAG)of 35 T2DM patients involving 189 coronary segments were collected.CAG findings were used as the gold standard for coronary lesion diagnosis to analyze the diagnostic value of CCTA for coronary lesions in T2DM patients.Results The sensitivity,specificity,positive predictive value and negative predictive value of CCTA were 75.86%,73.53%,70.97%and 78.13%,respectively,for diagnosing coronary stenosis in T2DM patients.A fair consistency existed between CCTA and CAG for diagnosing the severity of coronary stenosis in T2DM patients(Kappa value=0.491,P<0.05).Conclusion CCTA exhibits higher sensitivity and specificity for coronary lesion screening in T2DM patients,however,it has a fair consistency with CAG for diagnosing the severity of coronary stenosis,and may serve as a noninvasive detection approach for clinically screening coronary lesions in T2DM patients.