CAJ | 학술논문

目的：探讨冠状动脉C T血管成像分析糖尿病（DM ）和非DM 冠心病患者冠脉病变的差异，并对照分析超声心动图检查在左心室功能评估中的一致性。方法采用128层C T 和超声心动图对339例临床疑诊冠心病患者进行检查，分别统计DM和非DM组冠状动脉狭窄节段数；根据CT血管成像数据，计算出CTA的左心室舒张末期容积（end‐di‐astolic volume ，EDV）、收缩末期容积（end‐systolic volume ，ESV）以及射血分数（ejection fraction ，EF），并与超声心动图检查获得的数据进行一致性检验。结果 DM组冠心病发病率为93％，高于非DM 组为70％（ P ＝0．03）。DM 组共测定649个节段，其中发现271个节段有动脉硬化性斑块存在，非DM组共测定3080个节段，其中发现644个节段有斑块（ P＝0．00）。DM组冠状动脉狭窄节段数为4．6／人，非DM 组冠状动脉狭窄节段数为2．3／人，DM组受累冠状动脉节段数明显高于非DM组（ P＝0．02）；DM 组冠状动脉狭窄程度明显增高。CTA测量的EDV、ESV及EF与超声心功能指标无显著性差异（ P ＞0．05）。结论 MSCT能够显示DM组和非DM组冠脉病变程度差异，评价左心室功能的结果可靠，可以用于无症状DM患者冠心病的早期筛查。
목적：탐토관상동맥C T혈관성상분석당뇨병（DM ）화비DM 관심병환자관맥병변적차이，병대조분석초성심동도검사재좌심실공능평고중적일치성。방법채용128층C T 화초성심동도대339례림상의진관심병환자진행검사，분별통계DM화비DM조관상동맥협착절단수；근거CT혈관성상수거，계산출CTA적좌심실서장말기용적（end‐di‐astolic volume ，EDV）、수축말기용적（end‐systolic volume ，ESV）이급사혈분수（ejection fraction ，EF），병여초성심동도검사획득적수거진행일치성검험。결과 DM조관심병발병솔위93％，고우비DM 조위70％（ P ＝0．03）。DM 조공측정649개절단，기중발현271개절단유동맥경화성반괴존재，비DM조공측정3080개절단，기중발현644개절단유반괴（ P＝0．00）。DM조관상동맥협착절단수위4．6／인，비DM 조관상동맥협착절단수위2．3／인，DM조수루관상동맥절단수명현고우비DM조（ P＝0．02）；DM 조관상동맥협착정도명현증고。CTA측량적EDV、ESV급EF여초성심공능지표무현저성차이（ P ＞0．05）。결론 MSCT능구현시DM조화비DM조관맥병변정도차이，평개좌심실공능적결과가고，가이용우무증상DM환자관심병적조기사사。
Objective To investigate the differences of coronary artery lesions between diabetes mellitus (DM ) and non‐diabetic coronary heart disease (CHD) patients using coronary CT angiography (CTA) and the consistency with ultrasonic cardiogram in the left ventricular function evaluation .Methods 128‐layer spiral CT and ultrasonic cardiogram were per‐formed in 339 patients with CHD ,and the segment number of coronary artery stenosis was counted both in DM group and non‐DM group .End‐diastolic volume (EDV) ,end‐systolic volume (ESV) ,and ejection fraction (EF) were calculated ac‐cording to CTA and ultrasonic cardiogram data and a consistency check was made upon them .Results The incidence of CHD was 93% in DM group ,significantly higher than that in the non‐DM group which was 70% ( P =0 .03) .271 seg‐ments of artery atherosclerotic plaque were found in 649 segments in DM group ,644 segments of artery atherosclerotic plaque were found in 3080 segments in non‐DM group ( P =0 .00) .The segment number of coronary artery stenosis in DM group was 4 .6 per person ,significantly higher than that in the non‐DM group which was 2 .3 per person ( P=0 .02) . The severity of coronary artery stenosis was significantly increased in DM group .There was no significant difference in EDV ,ESV ,EF and ultrasonic cardiac function indexes between the two methods ( P >0 .05) .Conclusion MSCT can display the differences in the degree of coronary artery lesions between DM group and non‐DM group ,and it was reliable for evaluating the left ventricular function .MSCT can be applied to the early screening of asymptomatic DM patients with CHD .