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目的采用64层CT血管成像评价糖尿病患者冠状动脉旁路移植(CABG)术后桥血管病变的特征。方法收集39例冠状动脉CABG术后患者,其中临床确诊糖尿病患者20例,无糖尿病患者19例。应用64层螺旋CT行冠状动脉CTA检查,由两位有经验的医生来评估分析近期桥血管是否通畅、有无斑块及斑块性质进行分析。结果二组桥血管病变中,糖尿病患者的斑块检出率明显高于无糖尿病患者组(P<0.05),糖尿病组重度狭窄病变明显多于非糖尿病组(P<0.05)。前者以弥漫性钙化或混合斑块为主,管腔呈中、重度狭窄。后者以少量非钙化斑块为主,管腔以轻中、度狭窄为主,二组差异有统计学意义(P<0.05)。结论糖尿病患者旁路移植(CABG)术后桥血管有高度的冠状动脉病变危险性,糖尿病患者并发桥血管病变较非糖尿病患者严重,且以钙化或混合斑块为主。CTA可清晰显示冠状动脉桥血管图像,对临床评估冠心病风险具有重要价值。
Objective To evaluate the characteristics of posttransplant coronary artery bypass graft (CABG) in patients with diabetes mellitus using 64-slice CT angiography. Methods Thirty-nine patients with coronary artery CABG were enrolled. Among them, 20 were clinically diagnosed with diabetes and 19 were non-diabetic. Application of 64-slice spiral CT coronary artery CTA examination, by two experienced doctors to assess the recent analysis of whether the bridge of the patency of blood vessels, with or without plaque and the nature of the analysis. Results In the two groups, the detection rate of plaque in diabetic patients was significantly higher than that in non-diabetic patients (P <0.05). Severe stenosis in diabetic patients was more than that in non-diabetic patients (P <0.05). The former is mainly diffuse calcified or mixed plaque, the lumen was medium and severe stenosis. The latter with a small amount of non-calcified plaque dominated lumen with mild to moderate stenosis, the difference between the two groups was statistically significant (P <0.05). Conclusion The coronary arteries of bridging vessels after CABG surgery are at risk of coronary artery disease. Diabetic patients complicated with bridging vascular lesions are more serious than those without diabetes, and mainly calcified or mixed plaques. CTA can clearly show the images of coronary artery vessels and is of great value in the clinical assessment of the risk of coronary heart disease.