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目的应用电子束CT(EBT)心脏扫描,评价EBT在判断2型糖尿病冠状动脉病变中的应用价值。方法94例受试者行心脏EBT扫描,计算冠状动脉钙化(CAC)率、钙化积分、冠状动脉狭窄支数和软斑数,同时收集血糖、糖化血红蛋白(HbA1c)、血脂等相关临床信息。结果血糖异常组(包括糖耐量减低者、糖尿病者)、冠心病组CAC发生率较血糖正常组明显升高(93.33%,96.43%,90.91%∶56.00%,P<0.01),钙化积分有明显升高趋势,但差异无统计学意义,冠状动脉狭窄支数和软斑数有明显增加(2.200±2.024,2.964±1.915,2.273±1.679∶0.520±1.295,P<0.01和2.467±2.360,2.893±1.771,2.372±1.819∶0.511±1.197,P<0.01)。Pearson相关分析,发现钙化积分与年龄有明显相关(r=0.423,P<0.01),冠状动脉狭窄数与年龄(r=0.215,P<0.05)、餐后血糖(r=0.224,P<0.05)、胆固醇(r=0.275,P<0.01)密切相关。结论2型糖尿病患者有明显的冠状动脉病变,EBT钙化需与EBT增强扫描、三维血管重建结合,来共同判断糖尿病患者的冠状动脉病变状态。
Objective To evaluate the value of EBT in the diagnosis of coronary artery disease of type 2 diabetes mellitus by electron beam computed tomography (EBT) cardiac scan. Methods Ninety - four subjects underwent echocardiographic EBT scan. The coronary artery calcification (CAC) rate, calcification score, coronary artery stenosis count and soft plaque were calculated. The related clinical information such as blood glucose, HbA1c and blood lipid were also collected. Results The incidence of CAC in CHD group was significantly higher than that in normal group (93.33%, 96.43%, 90.91%, 56.00%, P <0.01), and the calcification score was significantly higher in patients with abnormal glucose (including those with impaired glucose tolerance and diabetes) (2.200 ± 2.024,2.964 ± 1.915,2.273 ± 1.679:0.520 ± 1.295, P <0.01 and 2.467 ± 2.360, 2.893 ± 2.95, respectively), but the difference was not statistically significant 1.771, 2.372 ± 1.819: 0.511 ± 1.197, P <0.01). (R = 0.223, P <0.05), postprandial blood glucose (r = 0.224, P <0.05), Pearson correlation analysis showed that the calcification score was significantly correlated with age (r = 0.423, , Cholesterol (r = 0.275, P <0.01). Conclusion Patients with type 2 diabetes have obvious coronary artery lesions. EBT calcification should be combined with EBT enhancement scan and 3D reconstruction to determine the coronary lesion status in diabetic patients.