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目的:利用双源CT(DSCT)血管成像技术探讨糖尿病与冠状动脉粥样硬化斑块形成之间的相关性。材料与方法:收集本院2013年4月到2014年8月接受DSCT冠状动脉造影检查的病例,以调查问卷作为分组依据,筛选出糖尿病组(n=300)和非糖尿病组(对照组n=300),其中糖尿病组根据病程的长短又分为2组:1组,糖尿病病程≤5年,共180例;2组,病程>5年共120例。观察并比较两组患者斑块的发生率、分布特点、狭窄程度及斑块类型。结果:病变累及血管支数及范围比较。糖尿病组冠脉3支血管病变发生率为27.5%,非糖尿病组为20.6%;糖尿病组弥漫性病变发生率为43.8%,非糖尿病组为17.4%,两组比较差异均有统计学意义(P<0.05)。狭窄程度比较:糖尿病组重度狭窄、完全闭塞的比例分别为7.9%、4.8%;非糖尿病组分别为3.7%、1.9%,糖尿病组狭窄程度较非糖尿病组增高,两组比较差异有统计学意义(P<0.05)。糖尿病2组重度狭窄、完全闭塞的比例分别为12.2%、7.8%,1组分别为0.93%、0%,两组之间差异有统计学意义(P<0.05)。斑块性质比较:糖尿病组混合斑块的发生率为51.4%,非糖尿病组为38.9%,而非钙化斑块的发生率,糖尿病组为43.8%,非糖尿病组为53.7%,两组比较差异均有统计学意义(P<0.05);糖尿病2组混合斑块的发生率为63.3%,1组为31.5%,两组比较差异亦有统计学意义。结论:DSCT冠状动脉造影能够准确评价糖尿病与冠脉斑块之间的关系。糖尿病患者冠脉斑块累及范围更广、管腔狭窄更严重、混合斑块发生率更高,并处于更易发生心血管事件的高危状态,随着病程的延长而加剧。
Objective: To explore the correlation between diabetes and coronary atherosclerotic plaque formation by dual-source CT (DSCT) angiography. Materials and Methods: The patients undergoing DSCT coronary angiography were collected from April 2013 to August 2014 in our hospital. According to the questionnaire as the basis of grouping, diabetic patients (n = 300) and non-diabetic patients (n = 300). Diabetes group was divided into two groups according to the course of the disease: group 1, duration of diabetes ≤ 5 years, a total of 180 cases; group 2, duration of disease> 5 years a total of 120 cases. The incidence of plaque, distribution characteristics, degree of stenosis and plaque type were observed and compared between two groups. Results: Lesions involved vascular count and range comparison. The prevalence of coronary artery angiography was 27.5% in diabetic group and 20.6% in non-diabetic group. The incidence of diffuse lesions was 43.8% in diabetic group and 17.4% in non-diabetic group, with significant difference between the two groups (P <0.05). The degree of stenosis in diabetic group was 7.9% and 4.8% respectively for severe stenosis and complete occlusion, while in non-diabetic group was 3.7% and 1.9% respectively. The degree of stenosis in diabetic group was higher than that in non-diabetic group, the difference was statistically significant (P <0.05). The rates of severe stenosis and complete occlusion in the two groups of diabetes were 12.2% and 7.8%, respectively, and those in the two groups were 0.93% and 0% respectively. There was significant difference between the two groups (P <0.05). The plaque quality comparison: the incidence of mixed plaque in diabetic group was 51.4%, non-diabetic group was 38.9%, while the incidence of non-calcified plaque in diabetic group was 43.8%, non-diabetic group was 53.7%, the difference between the two groups (P <0.05). The incidence of mixed plaque in 2 groups was 63.3% in diabetic group and 31.5% in group 1, and the differences between the two groups were also statistically significant. Conclusion: DSCT coronary angiography can accurately evaluate the relationship between diabetes and coronary plaque. Patients with diabetes have a wider range of coronary plaque, more severe stenosis, and a higher incidence of mixed plaques and are at a higher risk of developing cardiovascular events, exacerbating the disease’s duration.