CTA、MRA检查对糖尿病足下肢动脉病变的诊断价值及病变的影响因素分析

Analysis of the Diagnostic Value of CTA and MRA in Lower Extremity Arterial Lesions of Diabetic Foot and the Influencing Factors

目的:研究CT血管造影(CTA)、磁共振血管造影(MRA)检查对糖尿病足(DF)下肢动脉病变的诊断价值及病变的影响因素。方法:将我院从2017年1月~2020年1月收治的94例DF下肢动脉病变患者纳入研究,记作研究组。另取同期我院收治的94例单纯DF患者作为对照组。研究组患者均进行CTA以及MRA检查,比较两种检查方式对DF下肢动脉病变的检出情况。此外,比较两组基础疾病以及生化指标水平,并作多因素Logistic回归分析病变的影响因素。结果:MRA检查对DF下肢动脉病变的检出率为98.94%(93/94),高于CTA检查的91.49%(86/94)(P<0.05);MRA检查对DF下肢动脉病变轻度狭窄的检出率为43.62%(41/94),高于CTA检查的28.79%(28/94)(P<0.05)。研究组高血压、肥胖症人数占比高于对照组,且空腹血糖(FBG)、餐后2 h血糖(2hPG)及糖化血红蛋白(HbA1c)水平均高于对照组(P<0.05)。经多因素Logistic回归分析可得:高血压、肥胖症以及FBG、2hPG均是DF下肢动脉病变的危险因素(OR=1.195、2.331、5.391、3.274,P<0.05)。结论:MRA检查对DF下肢动脉病变的诊断价值较高,且高血压、肥胖症及FBG、2hPG水平的升高均可增加DF下肢动脉病变的发生风险。

Objective: To study the diagnostic value of CT angiography(CTA) and magnetic resonance angiography(MRA) in lower extremity arterial lesions of diabetic foot(DF) and the influencing factors. Methods: A total of 94 patients with lower extremity arterial lesions of DF who were admitted to our hospital from January 2017 to January 2020 were included in the study, and recorded as the study group. In addition, 94 patients with pure DF who were admitted to our hospital during the same period were taken as the control group. All patients in the study group were examined by CTA and MRA, and the detection of lower extremity arterial lesions of DF by the two methods was compared. In addition, the basic diseases and levels of biochemical indicators were compared between the two groups, and multiple logistic regression was used to analyze the influencing factors of pathological changes. Results: The detection rate of lower extremity arterial lesions of DF by MRA was 98.94%(93/94), which was higher than 91.49%(86/94) by CTA(P<0.05). The detection rate of mild stenosis of lower extremity arterial lesions of DF was 43.62%(41/94) by MRA, which was higher than 28.79%(28/94) by CTA(P<0.05). The proportion of hypertension and obesity in the study group were higher than those in the control group, and the levels of fasting blood glucose(FBG), 2 h postpranitarian blood glucose(2 hPG) and glycosylated hemoglobin(HbA1 c) were all higher than those in the control group(P<0.05). According to multivariate Logistic regression analysis showed that: hypertension, obesity, FBG and 2 h PG were all risk factors for lower extremity arterial lesions of DF(OR=1.195, 2.331, 5.391, 3.274;P<0.05). Conclusion: MRA examination is of high diagnostic value for lower extremity arterial lesions of DF, the hypertension, obesity and the increase levels of FBG and 2 hPG, which can increase the risk of lower extremity arterial lesions of DF.