中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
Chinese Journal of Evidence-Bases Cardiovascular Medicine
2015年
5期
693-695
,共3页
王秀杰%曾凡本%陈雯%马锦玲
王秀傑%曾凡本%陳雯%馬錦玲
왕수걸%증범본%진문%마금령
冠状动脉计算机断层血管摄影术%粥样硬化斑块%糖尿病%老年人
冠狀動脈計算機斷層血管攝影術%粥樣硬化斑塊%糖尿病%老年人
관상동맥계산궤단층혈관섭영술%죽양경화반괴%당뇨병%노년인
Coronary computed tomography angiography%Atherosclerotic plaque%Diabetes mellitus%Elderly people
目的：利用冠状动脉计算机断层血管摄影术（CCTA）评价糖尿病和非糖尿病胸痛患者冠状动脉病变及斑块的特点。方法选自2012年1月~2014年12月间山东省招远市人民医院以胸痛为症状接受64层冠状动脉CT检查且年龄大于60岁患者488例，其中合并糖尿病者221例，非糖尿病者267例，比较两组患者的冠状动脉粥样硬化斑块的分布与类型特点。随访1年，观察两组患者急性冠状动脉综合征事件存活率的预后分析。结果与非糖尿病组相比，糖尿病组患者冠状动脉多支病变（75.1%）及弥漫病变（43.9%）发生率明显高于非糖尿病组（37.8%、16.1%），且有更多的混合斑块发生率（82.4%vs.39.7%）；糖尿病组患者冠状动脉狭窄大于50%及75%发生率（61.5%、31.2%）高于非糖尿病组（36.0%、19.9%）。Kaplan-Meier生存曲线显示，在冠状动脉狭窄大于50%的患者中经过1年随访，糖尿病组患者非急性冠状动脉综合征事件存活率明显低于非糖尿病组，差异均有统计学意义（P＜0.05）。结论冠状动脉CT能够准确反映动脉粥样硬化斑块在糖尿病和非糖尿病患者之间的差异，有利于进行早期危险评估。
目的：利用冠狀動脈計算機斷層血管攝影術（CCTA）評價糖尿病和非糖尿病胸痛患者冠狀動脈病變及斑塊的特點。方法選自2012年1月~2014年12月間山東省招遠市人民醫院以胸痛為癥狀接受64層冠狀動脈CT檢查且年齡大于60歲患者488例，其中閤併糖尿病者221例，非糖尿病者267例，比較兩組患者的冠狀動脈粥樣硬化斑塊的分佈與類型特點。隨訪1年，觀察兩組患者急性冠狀動脈綜閤徵事件存活率的預後分析。結果與非糖尿病組相比，糖尿病組患者冠狀動脈多支病變（75.1%）及瀰漫病變（43.9%）髮生率明顯高于非糖尿病組（37.8%、16.1%），且有更多的混閤斑塊髮生率（82.4%vs.39.7%）；糖尿病組患者冠狀動脈狹窄大于50%及75%髮生率（61.5%、31.2%）高于非糖尿病組（36.0%、19.9%）。Kaplan-Meier生存麯線顯示，在冠狀動脈狹窄大于50%的患者中經過1年隨訪，糖尿病組患者非急性冠狀動脈綜閤徵事件存活率明顯低于非糖尿病組，差異均有統計學意義（P＜0.05）。結論冠狀動脈CT能夠準確反映動脈粥樣硬化斑塊在糖尿病和非糖尿病患者之間的差異，有利于進行早期危險評估。
목적：이용관상동맥계산궤단층혈관섭영술（CCTA）평개당뇨병화비당뇨병흉통환자관상동맥병변급반괴적특점。방법선자2012년1월~2014년12월간산동성초원시인민의원이흉통위증상접수64층관상동맥CT검사차년령대우60세환자488례，기중합병당뇨병자221례，비당뇨병자267례，비교량조환자적관상동맥죽양경화반괴적분포여류형특점。수방1년，관찰량조환자급성관상동맥종합정사건존활솔적예후분석。결과여비당뇨병조상비，당뇨병조환자관상동맥다지병변（75.1%）급미만병변（43.9%）발생솔명현고우비당뇨병조（37.8%、16.1%），차유경다적혼합반괴발생솔（82.4%vs.39.7%）；당뇨병조환자관상동맥협착대우50%급75%발생솔（61.5%、31.2%）고우비당뇨병조（36.0%、19.9%）。Kaplan-Meier생존곡선현시，재관상동맥협착대우50%적환자중경과1년수방，당뇨병조환자비급성관상동맥종합정사건존활솔명현저우비당뇨병조，차이균유통계학의의（P＜0.05）。결론관상동맥CT능구준학반영동맥죽양경화반괴재당뇨병화비당뇨병환자지간적차이，유리우진행조기위험평고。
Objective To review the characteristics of coronary artery lesion and atherosclerotic plaque by applying coronary computed tomography angiography (CCTA) in elderly patients with chest pain and with or without diabetes mellitus (DM).Methods The patients with chest pain (n=488, aged over 60) undergone 64-row CCTA scanner were chosen from Jan. 2012 to Dec. 2014, including 221 with DM (DM group) and 267 without DM (non-DM group). The distribution and type characteristics of coronary plaque were compared in 2 groups. The survival rate and prognosis of acute coronary syndrome events were observed after followed up for 1 y.Results The incidences of multi-vessel lesion (75.1%) and diffuse lesion (43.9%) of coronary artery were significantly higher in DM group than those in non-DM group (37.8%, 16.1%), and incidence of mixed plaque was higher in DM group than that in non-DM group (82.4%vs. 39.7%). The occurring rate of coronary stenosis (over 50% and over 75%) was higher in DM group (61.5%, 31.2%) than that in non-DM group (36.0%, 19.9%). Kaplan-Meier survival curve showed that the survival rate of acute coronary syndrome events in patients with coronary stenosis over 50% was significantly lower in DM group than that in non-DM group (P<0.05) after followed up for 1 y.Conclusion CCTA can accurately reflect the difference in atherosclerotic plaques between patients with or without DM, which is helpful to review early risk of cardiovascular events.
