64排螺旋CT冠状动脉成像在老年糖尿病患者冠状动脉病变中的诊断价值及准确率分析

The diagnostic value and accuracy of 64 slice spiral CT coronary angiography in coronary artery disease of elderly patients with diabetes mellitus

目的观察64排螺旋CT冠状动脉成像(CTA)在老年糖尿病(DM)患者冠状动脉病变中的诊断价值及准确率。方法选取2019年5月至2021年5月本院接诊的80例老年DM合并冠状动脉病变患者,均行冠状动脉造影(CAG)、CTA检查,评价两种检查方式对冠状动脉病变的显示情况,比较诊断效能、斑块情况。结果CAG显示80例患者共904支冠状动脉节段,其中正常496支(右冠状动脉96支、左回旋117支、左前降支194支、左主干89支)、狭窄408支(右冠状动脉110支、左回旋89支、左前降支196支、左主干13支),而CTA显示80例患者冠状动脉情况为正常483支(右冠状动脉92支、左回旋115支、左前降支188支、左主干88支)、狭窄421支(右冠状动脉114支、左回旋91支、左前降支202支、左主干14支)。CTA诊断准确率为94.58%(855/904)、灵敏度为95.59%(390/408)、特异度为93.75%(465/496)。80例患者(904支冠状动脉节段)中50例伴有斑块(双支及以上18例、单支32例),共135支冠状动脉节段(钙化斑块25支、混合斑块61支、软斑块49支)。结论CTA能有效诊断老年DM合并冠状动脉病变,准确率高,值得临床推广。

Objective To observe the diagnostic value and accuracy of 64 slice spiral CT coronary imaging(CTA)in coronary artery disease of elderly patients with diabetes mellitus(DM).Methods 80 elderly patients with DM complicated with coronary artery disease admitted to our hospital from May 2019 to May 2021 were selected for coronary angiography(CAG)and CTA examination.The display of coronary artery disease by the two examination methods was evaluated,and the diagnostic efficacy and plaque status were compared.Results CAG showed there were total 904 coronary segments in 80 patients,of which 496 were normal(96 right coronary arteries,117 left circumflex arteries,194 left anterior descending arteries,and 89 left main arteries),408 were stenosis(110 right coronary arteries,89 left circumflex arteries,196 left anterior descending arteries,and 13 left main arteries),while CTA showed that the coronary arteries in 80 patients were normal 483(92 right coronary arteries,115 left circumflex arteries,188 left anterior descending arteries,and 88 left main arteries),421 stenoses(114 right coronary arteries,91 left circumflex arteries,202 left anterior descending arteries,and 14 left main arteries).The diagnostic accuracy of CTAwas 94.58%(855/904),sensitivity was 95.59%(390/408),and specificity was 93.75%(465/496).Among 80 patients(904 coronary segments),50 were accompanied by plaques(18 with double or more branches,32 with single branch),with a total of 135 coronary segments(25 calcified plaques,61 mixed plaques,and 49 soft plaques).Conclusion CTA can effectively diagnose elderly DM with coronary artery disease,with high accuracy,and is worthy of clinical promotion.