摘要
目的利用640层MSCT结合血脂水平评估糖尿病(DM)和非DM冠心病患者冠脉病变范围及斑块组成特点。方法回顾分析广东茂名市人民医院心内科诊断为急性冠脉综合征并行640层MSCT检查的患者122例,依据是否合并DM分为两组,包括DM组58例和非MD组64例。分析CT图像,记录各患者冠脉病变范围和斑块组成特征。测定患者总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、HDL/LDL和甘油三酯(TG)水平。比较DM组和非DM组冠脉病变范围、斑块组成特征和血脂水平的差异。结果 DM组患者体重指数(BMI),吸烟和存在家族史的百分率均明显高于DM组(P<0.05)。DM组冠脉病变平均受累节段为6.8±2.2,明显高于非DM组3.5±1.2(P<0.01)。DM组与非DM组间冠脉斑块构成有差别,DM组冠脉斑块以软斑块(NCP)好发且明显高于非DM组(P<0.05),而钙化斑块(CP)和混合性斑块(MP)在两组之间发病率无统计学差异(P>0.05)。与非DM组比较,DM组的HDL-C、LDL-C和LDL-C/HDL-C水平均显著增高(P<0.01)。结论 MSCT能够清晰显示冠脉病变范围及斑块组成特征;冠心病合并DM组冠脉病变范围广,且斑块以NCP为主,血脂水平更高,预示有更高发生急性冠状动脉事件的可能性。
Objective To evaluate the scope and composition characteristics of coronary plaque using 640-section multi-spiral CT and inflammatory mediators in diabetics with coronary artery disease. Methods 122 patients with acute coronary syndrome in our hospital were recruted, all the patients underwent 640 slices CT exmination. Based on whether the patients are suffering from DM, they were divided into two group, one was DM group with 58 cases and the other was non-DM group with 64 cases. All CT images were analyzed, and the scope and composition characteristics of coronary plaque were recorded. Moreover, the level of total cholesterol （TC）, high-density lipoprotein cholesterol （HDL-C）, low-density lipoprotein cholesterol （LDL-C）, HDL/LDL and triglyceride （TG）were recorded. The scope and composition characteristics of plaque, blood lipid level were compared between DM and non-DM group. Result BMI, the proportion of smoking and DM family history in DM group were higher than non-DM group （P 〈 0.05）. The segmental lesions in DM group was （6.8 ±2.2）, higher than that in non-DM group （3.5 ± 1.2, P 〈 0.01 ）. The composition characteristics of coronary plaque was different between DM group and non-DM group. Non calcified plaque （NCP） had a higher incidences in DM group （P 〈 0.05 ）, whereas, there was no siginficant difference in calcified plaque （CP） and mixed plaque （MP） between DM group and non-DM group （P 〉 0.05 ）. Compared with non-DM group, the level of HDL-C, LDL-C and LDL-C/HDL-C was higher （P 〈 0.01 ） in DM group. Conclusion MSCT has the potential of clearly differentiating the scope and composition characteristics of coronary plaque. For DM patients with coronary artery disease, the coronary artery disease is more extensive, and the NPC incidence and the blood lipid level are both higher. The possibility of more acute coronary events was predicted in DM group.
出处
《功能与分子医学影像学（电子版）》
2017年第2期1183-1188,共6页
Functional and Molecular Medical Imaging(Electronic Edition)
基金
广东省茂名市科技局课题(20160334)
关键词
螺旋CT
冠心病
糖尿病
斑块
血脂
spiral CT
coronary heart disease
diabetes
plaque
blood lipid
