论文部分内容阅读
目的通过与金标准DSA的比较,分析应用双能(DE-CTA)检查2型糖尿病(T2DM)患者下肢血管病变(PAD)程度的准确性,以及PAD程度与相关危险因素的相关性。方法选择120例符合条件的2型糖尿病(T2DM)患者,所有患者均行下肢双能CTA检查以及DSA检查。将每个患者的一侧下肢血管按名称分成11个节段,两种方法一一比较;搜集每位相关患者的临床资料,对研究组(有PAD,120例)和对照组(无PAD,50例)的两组患者的餐后2 h血糖(2 h BG)、糖化血红蛋白(Hb A1c)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)以及高密度脂蛋白胆固醇(HDLC)进行测定及分析。结果通过对120例患者(2 640个血管节段)进行分析及比较,两类检查手段总的K值分别为0.909、0.961,两者的一致性非常好,而且双能CTA后处理方式的敏感度、特异度以及准确度都比较高,基本达到90%;单因素分析表明2h BG、Hb A1c、TC、LDL-C等因素是发生PAD的影响因素。而多因素分析表明TC是引起T2DM发生PAD的独立危险因素。结论双能CTA和PAD在分析T2DM患者发生PAD方面有非常好的一致性,可广泛应用于临床,成为用于PAD检查的一个高质量影像学检查手段。
Objective To compare the accuracy of the lower extremity vascular lesions (PAD) with the dual-energy (DE-CTA) in the detection of type 2 diabetes mellitus (T2DM) and the correlation between PAD and related risk factors by comparing with gold standard DSA. Methods 120 patients with type 2 diabetes mellitus (T2DM) were selected. All patients underwent dual-energy CTA and DSA examinations. Each patient’s lower extremity blood vessels were divided into 11 segments according to their names, and the two methods were compared one by one. The clinical data of each related patient were collected. The study group (PAD, 120 cases) and control group (without PAD, (2 h BG), Hb A1c, triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) High density lipoprotein cholesterol (HDLC) was measured and analyzed. Results By analyzing and comparing 120 patients (2 640 blood vessel segments), the total K values of the two test methods were 0.909 and 0.961, respectively. The consistency between the two was very good, and the sensitivity of dual-energy CTA post-treatment Degree, specificity and accuracy were all high, reaching 90%. Univariate analysis showed that 2h BG, Hb A1c, TC, LDL-C and other factors were the influencing factors of PAD. Multivariate analysis showed that TC was an independent risk factor for PAD in T2DM. Conclusions Dual-energy CTA and PAD have a very good agreement in the analysis of PAD in patients with T2DM, which can be widely used in clinic and become a high-quality imaging examination method for PAD examination.