摘要
目的探讨老年2型糖尿病(T2DM)合并冠状动脉粥样硬化性心脏病(CHD)患者冠状动脉CT血管造影(CCTA)参数与冠状动脉狭窄程度及血脂的关系。方法选取2022年3月至2024年3月收治的老年T2DM合并CHD患者62例,据冠状动脉钙化积分(Agatston钙化积分)分为轻度组21例(Agatston钙化积分为11~100分)、中度组26例(Agatston钙化积分为101~399分)和重度组15例(Agatston钙化积分≥400分)。均行CCTA检查,记录并比较不同Agatston钙化积分患者CCTA参数[最小管腔面积(MLA)、血管体积、总斑块体积(TPV)、钙化斑块体积(CPV)、斑块负荷(TPB)]及血脂指标[总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)],并采用Pearson相关性分析CCTA参数与Agatston钙化积分及血脂水平的关系。结果轻度组MLA高于中度组和重度组,TPV、CPV及TPB均低于中度组和重度组(P<0.05);且较中度组,重度组MLA更低,TPV、CPV及TPB均更高(P<0.05)。轻度组HDL-C水平高于中度组和重度组,TC、TG、LDL-C水平及Agatston钙化积分均低于中度组和重度组(P<0.05);且较中度组,重度组HDL-C更低,TC、TG、LDL-C水平及Agatston钙化积分均更高(P<0.05)。Pearson相关性分析显示,MLA与HDL-C呈正相关,与TC、TG、LDL-C及Agatston钙化积分均呈负相关(P<0.01);TPV、CPV及TPB均与HDL-C呈负相关,与TC、TG、LDL-C及Agatston钙化积分均呈正相关(P<0.05,P<0.01)。结论CCTA参数与老年T2DM合并CHD患者冠状动脉狭窄程度和血脂水平密切相关,通过监测CCTA参数有助于评估老年T2DM合并CHD患者冠状动脉狭窄严重程度。
Objective To explore the relationship between coronary CT angiography(CCTA)parameters and severity of coronary stenosis,blood lipid in elderly patients with type 2 diabetes mellitus(T2DM)and coronary heart disease(CHD).Methods A total of 62 elderly patients with T2DM and CHD treated between March 2022 and March 2024 were enrolled.According to scores of coronary artery calcification score(Agatston calcification),they were divided into mild group(Agatston calcification score 11-100 points,n=21),moderate group(Agatston calcification score,101-399 points,n=26)and severe group(Agatston calcification score≥400 points,n=15),and underwent CCTA.CCTA parameters[minimum lumen area(MLA),vessel volume,total plaque volume(TPV),calcified plaque volume(CPV),total plaque burden(TPB)]and blood lipid indicators[total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)]among the patients with different Agatston calcification scores were recorded and compared.The relationship between CCTA parameters and Agatston calcification score,blood lipid level was analyzed by Pearson correlation analysis.Results MLA was higher in the mild group than in the moderate group and the severe group,while TPV,CPV and TPB were lower than those in the moderate group and the severe group(P<0.05).MLA was lower in the severe group than in the moderate group,while TPV,CPV and TPB were lower(P<0.05).HDL-C was higher in the mild group than in the moderate group and the severe group,while the levels of TC,TG and LDL-C,and Agatston calcification score were lower than those in the moderate group and the severe group(P<0.05).Compared with the moderate group,HDL-C was lower,while the levels of TC,TG and LDL-C,and Agatston calcification score were higher in the severe group(P<0.05).Pearson correlation analysis showed that MLA was positively correlated with HDL-C,while negatively correlated with TC,TG,LDL-C and Agatston calcification score(P<0.01);TPV,CPV and TPB were negatively correlated with HDL-C,while positively correlated with TC,TG,LDL-C and Agatston calcification score(P<0.05,P<0.01).Conclusion CCTA quantitative parameters are closely related to the severity of coronary stenosis and blood lipid level in elderly patients with T2DM and CHD.Monitoring CCTA quantitative parameters is beneficial to evaluate the severity of coronary stenosis in elderly patients with T2DM and CHD.
作者
许妍
郑春生
黄柿兵
杨龙林
尹育计
王书健
王安
XU Yan;ZHENG Chunsheng;HUANG Shibing;YANG Longlin;YIN Yuji;WANG Shujian;WANG An(Department of Radiology,Anqing Petrochemical Hospital,Nanjing Drum Tower Hospital Group,Anqing,Anhui 246000,China;Department of Laboratory,Anqing Petrochemical Hospital,Nanjing Drum Tower Hospital Group,Anqing,Anhui 246000,China;Department of Endocrinology,Anqing Petrochemical Hospital,Nanjing Drum Tower Hospital Group,Anqing,Anhui 246000,China)
出处
《临床误诊误治》
2025年第17期29-33,共5页
Clinical Misdiagnosis & Mistherapy
基金
安庆市2023年度医疗卫生类自筹经费科技计划项目(2023Z6005)
安徽省高等学校科学研究项目(2023AH053434)。
关键词
糖尿病
2型
冠心病
冠状动脉CT血管成像
冠状动脉狭窄
最小管腔面积
三酰甘油
相关性
diabetes mellitus,type 2
coronary heart disease
coronary CT angiography
coronary stenosis
minimum lumen area
triacylglycerol
correlation
