冠脉CT血管成像在糖尿病、高血压患者冠脉斑块特点识别中的价值

Value of Coronary Computed Tomography Angiography in Coronary Plaque Characteristics within Diabetes and Hypertension

目的利用冠脉CT血管成像无创性分析糖尿病和高血压患者冠脉斑块特点。方法回顾性分析2017年7月至2018年10月入宁夏回族自治区人民医院就诊的高血压(95例)、糖尿病(23例)、高血压合并糖尿病(68例)以及对照组(60例)患者的临床资料,四组患者均行256排螺旋CT冠脉血管成像检查(CCTA),利用卡方检验比较各组患者冠脉斑块分布、支数、性质及冠脉狭窄程度组间差异。结果四组患者冠脉斑块发生率差异有统计学意义(P=0.001),冠脉斑块多分布于左前降支差异无统计学意义(P=0.515),多支冠脉受累差异有统计学意义(P<0.001),以糖尿病合并高血压组中比例最高。四组患者冠脉斑块类型中非钙化斑块的发生率差异有统计学意义(P<0.001),病例组更易发生冠脉狭窄(P<0.001),轻度、中度及重度冠脉狭窄差异均有统计学意义(P均<0.05)。结论糖尿病、高血压的存在均可增加冠脉斑块发生率,更易导致冠脉狭窄,冠脉CCTA在冠脉斑块无创性识别及性质分析中存在潜力。

Objective To evaluate the coronary plaque characteristics in diabetes and hypertension noninvasively by coronary computed tomography angiography(CCTA).Methods Total 246 subjects(hypertension 95,diabetes 23,hypertension combined with diabetes 68,and control 60)were selected and analyzed retrospectively from July 2017 to October 2018.Four groups underwent CCTA imaged by 256-row computed tomography,then the distribution,type,range and narrow extent of coronary plaque were reviewed and compared with chi-square test.Results There was significant difference in the incidence of coronary plaque among four groups(P=0.001).The LAD was the most easily occurred coronary,and there was no significant difference among four groups(P>0.05).There was significant difference in incidence of multi-vessel lesion of coronary plaque among four groups(P<0.001),and the highest incidence rate was occurred in the hypertension combined with diabetes group.There was significant difference in incidence of non-calcified plaque among the four groups(P<0.001).The coronary narrowness was more easily occurred in three case groups,and there was significant difference among four groups(P<0.001),in addition,there were significant differences in the incidence of slight,mild and severe narrowness of coronary among four groups(P all<0.05).Conclusion The incidence of coronary plaque and narrowness were increased in diabetes and hypertension,especially in diabetes.Besides CCTA is potential in detecting and analyzing on characteristics of coronary plaque noninvasively.