冠状动脉CT造影结合颈动脉超声与血清学标志物评价2型糖尿病合并冠心病的临床意义

发布时间：2018-01-09 04:06

本文关键词：冠状动脉CT造影结合颈动脉超声与血清学标志物评价2型糖尿病合并冠心病的临床意义　出处：《中国糖尿病杂志》2016年10期 　论文类型：期刊论文

【摘要】：目的运用螺旋CT冠状动脉造影(CCTA)结合颈动脉超声、血清学标志物分析T2DM合并冠心病(CHD)患者冠状动脉与颈动脉病变的相关性,为评估冠状动脉早期病变提供诊断依据。方法选取2014年1月至2015年12月在两家医院心内科和内分泌科住院诊断为CHD患者95例,根据有无T2DM病分为单纯CHD组(n=45)和T2DM合并CHD组(n=50),比较两组冠状动脉、颈动脉病变程度,高敏C-反应蛋白(hsC-RP)及FFA的差异。结果 CCTA显示,T2DM合并CHD组以双支和3支冠脉病变为主,与单纯CHD组比较,差异有统计学意义(40.0%vs 24.5%,50.0%vs 31.0%,P0.05),右冠状动脉、左回旋支斑块更多出现在T2DM合并CHD组,冠脉双支和3支病变组颈动脉斑块数较单支病变组多(P0.05)。T2DM合并CHD组冠状动脉斑块、颈动脉斑块检出率、软斑块所占比例均高于单纯CHD组(P0.05)。T2DM合并CHD组hsC-RP、FFA均高于单纯CHD组(P0.01)。非钙化斑块组hsC-RP、FFA较钙化斑块组高(P0.05)。随着冠状动脉病变分支增加,hsC-RP、FFA逐渐升高。Spearman相关分析表明,hsC-RP与FFA呈正相关(r=0.733,P0.01),hsC-RP水平与冠状动脉病变支数均呈正相关(CHD组r=0.835,T2DM合并CHD组r=0.892;P0.01)。结论CCTA显示,T2DM合并CHD冠脉斑块以软斑块和混合性斑块为主,冠状动脉病变广泛,颈动脉超声提示外周血管斑块数越多,冠状动脉病变支数越多,病变越严重。临床上联合CCTA、颈动脉超声及hsC-RP、FFA水平检测可提高T2DM合并CHD确诊率,降低假阳性,值得推广应用。
[Abstract]:Objective to analyze the correlation between coronary artery disease and coronary artery disease in patients with T2DM complicated with coronary artery disease (CHD) by spiral CT coronary angiography (CCTAA) combined with carotid ultrasound and serological markers. Methods from January 2014 to December 2015, 95 patients with CHD were hospitalized in cardiology and endocrine department in two hospitals. Patients with T2DM were divided into CHD group (n = 45) and T2DM complicated with CHD group (n = 50). The degree of coronary artery and carotid artery lesion was compared between the two groups. Results CCTA showed that T2DM combined with CHD mainly consisted of two-vessel and three-vessel coronary artery disease, compared with CHD group. The difference was statistically significant (40. 0 vs 24. 5) and 50. 0% vs 31. 0% P0.05, right coronary artery. The number of carotid plaques in T2DM combined with CHD group was more than that in single vessel lesion group. The number of carotid plaque in T2DM combined with CHD group was more than that in single vessel lesion group. The detection rate of carotid plaques in soft plaque group was higher than that in CHD group (P 0.05). T2DM combined with CHD group was higher than hsC-RP group. FFA was higher in CHD group than that in CHD group, and in non-calcified plaque group, it was higher than that in calcified plaque group (P 0.05). Spearman correlation analysis showed that hsC-RP was positively correlated with FFA. There was a positive correlation between the level of hsC-RP and the number of coronary artery lesion branches. Conclusion CCTA showed that soft plaque and mixed plaque were the main coronary plaques in T2DM complicated with CHD. Coronary artery lesions were extensive, and carotid ultrasound showed that the number of peripheral plaques increased. The more the number of coronary artery lesions, the more serious the lesion. The combination of CCTA, carotid ultrasound and FFA level of hsC-RPNs can improve the diagnosis rate of T2DM with CHD and reduce false positive. It is worth popularizing and applying.
【作者单位】：广州医科大学附属广州市第十二人民医院心血管内科;广东省第二人民医院内分泌科;广州医科大学附属广州市第十二人民医院内分泌科;广州医科大学附属广州市第十二人民医院医学影像科;
【分类号】：R541.4;R587.1
【正文快照】： CHD group were detected more than in CHD group.The plaque number of peripheral vascular in two andthree branches lesion groups were higher than in single branch group[(1.94±0.08)vs(3.01±1.05)vs(1.37±0.07)n,P0.05].The coronary plaques,the rate of caro

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