發(fā)布時(shí)間：2018-01-09 04:06

  本文關(guān)鍵詞：冠狀動(dòng)脈CT造影結(jié)合頸動(dòng)脈超聲與血清學(xué)標(biāo)志物評(píng)價(jià)2型糖尿病合并冠心病的臨床意義　出處：《中國糖尿病雜志》2016年10期 　論文類型：期刊論文

  更多相關(guān)文章： 冠狀動(dòng)脈CT造影 彩色多普勒超聲 高敏C反應(yīng)蛋白 游離脂肪酸 糖尿病 型

【摘要】：目的運(yùn)用螺旋CT冠狀動(dòng)脈造影(CCTA)結(jié)合頸動(dòng)脈超聲、血清學(xué)標(biāo)志物分析T2DM合并冠心病(CHD)患者冠狀動(dòng)脈與頸動(dòng)脈病變的相關(guān)性,為評(píng)估冠狀動(dòng)脈早期病變提供診斷依據(jù)。方法選取2014年1月至2015年12月在兩家醫(yī)院心內(nèi)科和內(nèi)分泌科住院診斷為CHD患者95例,根據(jù)有無T2DM病分為單純CHD組(n=45)和T2DM合并CHD組(n=50),比較兩組冠狀動(dòng)脈、頸動(dòng)脈病變程度,高敏C-反應(yīng)蛋白(hsC-RP)及FFA的差異。結(jié)果 CCTA顯示,T2DM合并CHD組以雙支和3支冠脈病變?yōu)橹?與單純CHD組比較,差異有統(tǒng)計(jì)學(xué)意義(40.0%vs 24.5%,50.0%vs 31.0%,P0.05),右冠狀動(dòng)脈、左回旋支斑塊更多出現(xiàn)在T2DM合并CHD組,冠脈雙支和3支病變組頸動(dòng)脈斑塊數(shù)較單支病變組多(P0.05)。T2DM合并CHD組冠狀動(dòng)脈斑塊、頸動(dòng)脈斑塊檢出率、軟斑塊所占比例均高于單純CHD組(P0.05)。T2DM合并CHD組hsC-RP、FFA均高于單純CHD組(P0.01)。非鈣化斑塊組hsC-RP、FFA較鈣化斑塊組高(P0.05)。隨著冠狀動(dòng)脈病變分支增加,hsC-RP、FFA逐漸升高。Spearman相關(guān)分析表明,hsC-RP與FFA呈正相關(guān)(r=0.733,P0.01),hsC-RP水平與冠狀動(dòng)脈病變支數(shù)均呈正相關(guān)(CHD組r=0.835,T2DM合并CHD組r=0.892;P0.01)。結(jié)論CCTA顯示,T2DM合并CHD冠脈斑塊以軟斑塊和混合性斑塊為主,冠狀動(dòng)脈病變廣泛,頸動(dòng)脈超聲提示外周血管斑塊數(shù)越多,冠狀動(dòng)脈病變支數(shù)越多,病變?cè)絿?yán)重。臨床上聯(lián)合CCTA、頸動(dòng)脈超聲及hsC-RP、FFA水平檢測(cè)可提高T2DM合并CHD確診率,降低假陽性,值得推廣應(yīng)用。
[Abstract]:Objective to analyze the correlation between coronary artery disease and coronary artery disease in patients with T2DM complicated with coronary artery disease (CHD) by spiral CT coronary angiography (CCTAA) combined with carotid ultrasound and serological markers. Methods from January 2014 to December 2015, 95 patients with CHD were hospitalized in cardiology and endocrine department in two hospitals. Patients with T2DM were divided into CHD group (n = 45) and T2DM complicated with CHD group (n = 50). The degree of coronary artery and carotid artery lesion was compared between the two groups. Results CCTA showed that T2DM combined with CHD mainly consisted of two-vessel and three-vessel coronary artery disease, compared with CHD group. The difference was statistically significant (40. 0 vs 24. 5) and 50. 0% vs 31. 0% P0.05, right coronary artery. The number of carotid plaques in T2DM combined with CHD group was more than that in single vessel lesion group. The number of carotid plaque in T2DM combined with CHD group was more than that in single vessel lesion group. The detection rate of carotid plaques in soft plaque group was higher than that in CHD group (P 0.05). T2DM combined with CHD group was higher than hsC-RP group. FFA was higher in CHD group than that in CHD group, and in non-calcified plaque group, it was higher than that in calcified plaque group (P 0.05). Spearman correlation analysis showed that hsC-RP was positively correlated with FFA. There was a positive correlation between the level of hsC-RP and the number of coronary artery lesion branches. Conclusion CCTA showed that soft plaque and mixed plaque were the main coronary plaques in T2DM complicated with CHD. Coronary artery lesions were extensive, and carotid ultrasound showed that the number of peripheral plaques increased. The more the number of coronary artery lesions, the more serious the lesion. The combination of CCTA, carotid ultrasound and FFA level of hsC-RPNs can improve the diagnosis rate of T2DM with CHD and reduce false positive. It is worth popularizing and applying.
【作者單位】： 廣州醫(yī)科大學(xué)附屬廣州市第十二人民醫(yī)院心血管內(nèi)科;廣東省第二人民醫(yī)院內(nèi)分泌科;廣州醫(yī)科大學(xué)附屬廣州市第十二人民醫(yī)院內(nèi)分泌科;廣州醫(yī)科大學(xué)附屬廣州市第十二人民醫(yī)院醫(yī)學(xué)影像科;
【分類號(hào)】：R541.4;R587.1
【正文快照】： CHD group were detected more than in CHD group.The plaque number of peripheral vascular in two andthree branches lesion groups were higher than in single branch group[(1.94±0.08)vs(3.01±1.05)vs(1.37±0.07)n,P0.05].The coronary plaques,the rate of caro

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