CAJ | 학술논문

目的：研究2型糖尿病患者双下肢动脉病变MSCTA影像表现，并探讨影响双下肢动脉病变的主要危险因素。方法61例患者行双下肢动脉MSCTA检查，运用MPR、MIP、VR等后处理分析动脉硬化斑块的分布情况及各节段狭窄程度等。详细记录患者年龄、病史、踝臂指数、生化指标（总胆固醇（TC），甘油三酯（TG），高密度脂蛋白（HDL-C），低密度脂蛋白（LDL-C））。运用Logistic回归分析双下肢动脉狭窄及踝臂指数的主要危险因素。结果61例均扫描成功，共1281段血管：327段有硬化斑块；28段轻度狭窄，21段中度狭窄，10段重度狭窄，14段闭塞。硬化斑块主要好发于上段（腘动脉以上），礸2＝115．371，P ＜0．001；狭窄多发生在下段（腘动脉及其以下），礸2＝13．523，P ＜0．001。下肢动脉狭窄危险因素有年龄、病史和TC异常，TC异常是独立危险因素（OR＝7．860，95％ CI：1．988～31．077）；踝臂指数异常危险因素为动脉狭窄和TC异常，动脉狭窄是独立危险因素（OR＝28．310，95％ CI：5．411～148．121）。结论 MSCTA可以清楚、准确判断2型糖尿病双下肢血管的病变。对于踝臂指数异常或者 TC升高的糖尿病患者，更容易伴有双下肢动脉的狭窄，建议对此类患者有必要进行临床干预和进一步行MSCTA检查。
목적：연구2형당뇨병환자쌍하지동맥병변MSCTA영상표현，병탐토영향쌍하지동맥병변적주요위험인소。방법61례환자행쌍하지동맥MSCTA검사，운용MPR、MIP、VR등후처리분석동맥경화반괴적분포정황급각절단협착정도등。상세기록환자년령、병사、과비지수、생화지표（총담고순（TC），감유삼지（TG），고밀도지단백（HDL-C），저밀도지단백（LDL-C））。운용Logistic회귀분석쌍하지동맥협착급과비지수적주요위험인소。결과61례균소묘성공，공1281단혈관：327단유경화반괴；28단경도협착，21단중도협착，10단중도협착，14단폐새。경화반괴주요호발우상단（객동맥이상），찰2＝115．371，P ＜0．001；협착다발생재하단（객동맥급기이하），찰2＝13．523，P ＜0．001。하지동맥협착위험인소유년령、병사화TC이상，TC이상시독립위험인소（OR＝7．860，95％ CI：1．988～31．077）；과비지수이상위험인소위동맥협착화TC이상，동맥협착시독립위험인소（OR＝28．310，95％ CI：5．411～148．121）。결론 MSCTA가이청초、준학판단2형당뇨병쌍하지혈관적병변。대우과비지수이상혹자 TC승고적당뇨병환자，경용역반유쌍하지동맥적협착，건의대차류환자유필요진행림상간예화진일보행MSCTA검사。
Objective To study manifestations of 16-detector row CT angiography and main risk factors of Lower ex-tremities vascular disease in patients with type 2 diabetes .Methods 61 cases lower extremities vascular were estimated by MSCTA .Locations of atherosclerotic plaques and the degree of stenosis of all segments were carefully analyzed using the post-processing technicals of MPR ,MIP ,VR et al .Then ,the patient's age ,duration ,ABI ,TC ,TG ,HDL-C ,LDL-C were analyzed using Logistic regression to find the risk factors of lower extremities vascular stenosis and ABI abnormality . Results 61 cases of MSCTA were performed successfully .327(of 1281) segments presented with atherosclerotic plaques ;28 ,21 ,10 ,14(out of 1281) Segments were found with mild ,moderate ,serious stenosis and occlusion respectively .Up-per segments (above the popliteal artery lever ) were found frequently with atherosclerotic plaques compared with lower segments (including popliteal artery ) ,χ2=115 .371 ,P<0 .001 ;While ,the stenosis were more often found in lower seg-ments ,χ2=13 .523 ,P <0 .001 .Patient's age ,duration ,elevated TC were the risk factors of lower extremities vascular stenosis ,the elevated TC was the independent risk factor (OR= 7 .860 ,95% CI:1 .988~31 .077) .Elevated TC and vascu-lar stenosis were the risk factors of ABI abnormality ,while the latter was found as the independrisk factor (OR=28 .310 , 95% CI:5 .411~148 .121) .Conclusion The 16-detector row CT angiography can provide accurate diagnosis of lower ex-tremities vascular disease .The diabetes patient with TC elevated or ABI abnormality may be suggested as a candidate to conduct clinical interventional treatment or MSCTA performance further .