双能CTA对2型糖尿病下肢血管病变的评估及危险因素相关性研究

发布时间：2018-03-02 01:23

本文关键词： 型糖尿病双能CT 下肢血管病变数字减影血管造影　出处：《中国地方病防治杂志》2017年04期 　论文类型：期刊论文

【摘要】：目的通过与金标准DSA的比较,分析应用双能(DE-CTA)检查2型糖尿病(T2DM)患者下肢血管病变(PAD)程度的准确性,以及PAD程度与相关危险因素的相关性。方法选择120例符合条件的2型糖尿病(T2DM)患者,所有患者均行下肢双能CTA检查以及DSA检查。将每个患者的一侧下肢血管按名称分成11个节段,两种方法一一比较;搜集每位相关患者的临床资料,对研究组(有PAD,120例)和对照组(无PAD,50例)的两组患者的餐后2 h血糖(2 h BG)、糖化血红蛋白(Hb A1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)以及高密度脂蛋白胆固醇(HDLC)进行测定及分析。结果通过对120例患者(2 640个血管节段)进行分析及比较,两类检查手段总的K值分别为0.909、0.961,两者的一致性非常好,而且双能CTA后处理方式的敏感度、特异度以及准确度都比较高,基本达到90%;单因素分析表明2h BG、Hb A1c、TC、LDL-C等因素是发生PAD的影响因素。而多因素分析表明TC是引起T2DM发生PAD的独立危险因素。结论双能CTA和PAD在分析T2DM患者发生PAD方面有非常好的一致性,可广泛应用于临床,成为用于PAD检查的一个高质量影像学检查手段。
[Abstract]:Objective to analyze the accuracy of DE-CTAs in detecting the degree of lower extremity vascular lesions in patients with type 2 diabetes mellitus (T2DM) by comparing with gold standard DSA. Methods 120 eligible patients with type 2 diabetes mellitus (T2DM) were selected. All patients were examined by dual energy CTA and DSA. Each patient's lower extremity vessels were divided into 11 segments according to their names. The two methods were compared one by one, and the clinical data of each patient were collected. The study group (120 cases with PADN) and the control group (50 cases without PADN) were treated with 2 h postprandial blood glucose (BGG), glycosylated hemoglobin (HbA1cN), triglyceride (TGN), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C). HDLC was measured and analyzed. Results 120 patients with 2 640 vascular segments were analyzed and compared. The total K value of the two methods was 0.909 ~ 0.961.The consistency of the two methods was very good, and the sensitivity, specificity and accuracy of the dual-energy CTA post-processing were high. Univariate analysis showed that the factors such as 2h BGG HbA1cTCLDL-C were the influencing factors of PAD, while the multivariate analysis showed that TC was the independent risk factor of T2DM PAD. Conclusion Dual-energy CTA and PAD can be used to analyze the occurrence of PAD in T2DM patients. There is very good consistency, It can be widely used in clinic and become a high-quality imaging method for PAD.
【作者单位】：北华大学附属医院内分泌科;吉林省地方病第二防治研究所;
【分类号】：R587.2

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