64排双源CT对T2DM合并冠心病患者冠脉狭窄程度及斑块稳定性的诊断价值研究

doi:10.7517/issn.1674.190907

摘要/Abstract

摘要： 本文为探讨64排双源CT对2型糖尿病（T2DM）合并冠心病患者冠脉狭窄程度及斑块稳定性的诊断价值，选择2015年2月~2018年2月我院接诊的90例冠心病患者进行研究，合并T2DM者设为观察组（n=49），未合并T2DM者设为对照组（n=41），比较多排双源CT对冠脉狭窄程度及斑块稳定性的诊断价值。观察组软斑块和混合斑块数量均显著高于对照组，钙化斑块数量则低于对照组，差异具有统计学意义（P<0.05）；两组患者冠状动脉Ⅰ级、Ⅱ级、Ⅳ级狭窄无明显差异（P>0.05）；观察组Ⅲ级狭窄显著高于对照组（P<0.05）；64排双源CT对≥ 50%冠状动脉狭窄诊断的灵敏度最低，随病变加重，灵敏度逐渐上升。阳性预测值随病变增加而增加，但都较阴性预测值为低，表明64排双源CT评价冠状动脉病变时存在高估现象；冠状动脉钙化较为严重者，不同钙化程度对诊断的影响总体表现为随着钙化程度的增加其诊断特异性下降，但仍可保持较高的灵敏度和准确率。本研究证实多排双源CT对T2DM合并冠心病患者冠脉狭窄程度及斑块稳定性的诊断价值较高，可帮助临床提供正确诊断，以选择合适的治疗方案。

关键词: 多排双源CT, 2型糖尿病, 冠心病, 冠脉狭窄程度, 斑块稳定性

Abstract: The aim of this paper is to analyse the diagnostic value of 64-slice spiral CT in the degree of coronary artery stenosis and plaque stability of Type 2 diabetes mellitus(T2DM) patients with coronary heart disease. 90 patients with coronary heart disease received in our hospital from February 2015 to February 2018 were selected and divided into two groups. One is the observation group (n=49), which with the combination of T2DM, the other is the control group (n=41), which without the combination of T2DM. Soft plaque and mixed plaque in the observation group were significantly more than those in the control group, and calcified plaque were significantly less than those in the control group. There was no significant difference in grade Ⅰ, Ⅱ and Ⅳ coronary artery stenosis between the two groups (P>0.05). Grade Ⅲ stenosis in the observation group was significantly higher than that in the control group (P<0.05). The sensitivity of 64-slice spiral CT in diagnosing ≥ 50% coronary artery stenosis was the lowest, but it gradually increased with the pathological deterioration. The positive predictive value increased with the pathological deterioration, but all of them were lower than the negative predictive value, indicating that there was an overestimation in the evaluation of coronary artery lesions with 64-slice spiral CT. For the patients with relatively serious coronary artery calcification, the diagnostic specificity decreases with the increase of calcification degrees, but high sensitivity and accuracy can still be maintained. In conclusion, multi-slice spiral CT has a high diagnostic value for the degree of coronary artery stenosis and plaque stability in patients with T2DM complicated with coronary heart disease, which can help to provide correct diagnosis and select appropriate treatment plan in clinical practice.

Key words: multi-slice spiral CT, type 2 diabetes, coronary heart disease, degree of coronary stenosis, plaque stability

中图分类号:

王朝兵, 李旭, 徐盼, 赵霞. 64排双源CT对T2DM合并冠心病患者冠脉狭窄程度及斑块稳定性的诊断价值研究[J]. 影像科学与光化学, 2020, 38(2): 266-271.

WANG Chaobing, LI Xu, XU Pan, ZHAO Xia. Analysis of the Diagnostic Value of 64-slice Spiral CT in the Degree of Coronary Artery Stenosis and Plaque Stability of T2DM Patients with Coronary Heart Disease[J]. Imaging Science and Photochemistry, 2020, 38(2): 266-271.

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