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目的:应用光学相干断层成像(optical coherence tomography, OCT)评价糖尿病与非糖尿病患者颈动脉斑块特征及颈动脉支架置入术(carotid artery stenting, CAS)术后即刻结果。方法:回顾性纳入2014年1月至2019年3月在东部战区总医院神经内科行CAS，并且术前和术后均行OCT检查的患者。比较糖尿病组和非糖尿病组临床特征、颈动脉斑块OCT特征以及CAS术后即刻结果。对支架贴壁不良的危险因素进行分析。结果:共纳入46例患者，年龄(64.02±8.32)岁，男性41例(89.1%)。其中糖尿病组20例(43.5%)，非糖尿病组26例(56.5%)。糖尿病组薄纤维帽粥样硬化斑块(40.0%对7.7%；n χ2＝5.166，n P＝0.023)、斑块破裂(55.0%对23.1%；n χ2＝4.945，n P＝0.026)和巨噬细胞浸润(60.0%对30.8%；n χ2＝3.930，n P＝0.047)患者比例均显著高于非糖尿病组。多变量n logistic回归分析显示，年龄较大[优势比(odds ratio, n OR)1.208，95%置信区间(confidence interval, n CI)1.033～1.413；n P＝0.018]、冠心病(n OR 15.953，95% n CI 1.142～222.952；n P＝0.040)、饮酒(n OR 6.192，95% n CI 1.098～34.923；n P＝0.039)和收缩压较低(n OR 0.944，95% n CI 0.894～0.997；n P＝0.037)与支架贴壁不良独立相关。n 结论:与非糖尿病患者相比，糖尿病患者的颈动脉斑块可能更不稳定。年龄较大、冠心病、饮酒和收缩压较低与CAS术后支架贴壁不良相关。OCT能显示颈动脉斑块特征和CAS术后即刻情况，可为治疗决策提供有力证据。“,”Objective:To evaluate the characteristics of carotid plaque and the immediate outcomes after carotid artery stenting (CAS) in diabetic and non-diabetic patients by optical coherence tomography (OCT).Methods:Patients underwent CAS and OCT before and after operation in the Department of Neurology, Jinling Hospital from January 2014 to March 2019 were enrolled retrospectively. The clinical features, the characteristics of carotid plaque on OCT and the immediate outcomes after CAS were compared between diabetic group and non-diabetic group. The risk factors of stent malapposition were analyzed.Results:A total of 46 patients were enrolled. Their age was 64.02±8.32 years and 41 were males (89.1%). There were 20 patients (43.5%) in the diabetes group and 26 (56.5%) in the non-diabetes group. The proportions of atherosclerotic plaque with thin fibrous cap (40.0% n vs. 7.7%; n χ2=5.166, n P=0.023), plaque rupture (55.0% n vs. 23.1%; n χ2=4.945, n P=0.026) and macrophage infiltration (60.0% n vs. 30.8%; n χ2=3.930, n P=0.047) in the diabetic group were significantly higher than those in the non-diabetic group. Multivariate n logistic regression analysis showed that older age (odds ratio [n OR] 1.208, 95% confidence interval [n CI] 1.033-1.413; n P=0.018), coronary heart disease (n OR 15.953, 95% n CI 1.142-222.952; n P=0.040), alcohol consumption (n OR 6.192, 95% n CI 1.098-34.923; n P=0.039) and lower systolic blood pressure (n OR 0.944, 95% n CI 0.894-0.997; n P=0.037) were independently associated with stent malaposition.n Conclusion:Compared with the non-diabetic patients, carotid plaque in diabetic patients may be more unstable. Older age, coronary heart disease, alcohol consumption and lower systolic blood pressure were associated with stent malaposition after carotid stenting. OCT can reveal the characteristics of carotid plaque and the immediate outcomes after CAS, which can provide strong evidence for treatment decision.