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目的采用64层CT血管成像(CTA)探讨糖尿病患者下肢动脉硬化闭塞症的病变特点。资料与方法62例临床确诊下肢动脉硬化闭塞症的患者按照有无糖尿病合并症分为糖尿病组(DM)及单纯高血压组(HP),分别为33例和29例。使用64层螺旋CT行下肢动脉CTA检查,采用动脉造影的12分段积分法将下肢动脉分为12个节段,分析各个血管节段的斑块分布情况(斑块检出率)及斑块性质,并分别对各个节段的管腔狭窄程度进行对比分析。结果在膝以上大动脉(腘动脉及其以上血管)病变中,两组血管的斑块检出率未见统计学差异(P>0.05),且均以混合斑块为主;动脉病变狭窄程度积分DM组为左侧:6.51±3.47,右侧:6.96±3.08;HP组为左侧:4.86±2.06,右侧:5.34±2.02。两组未见统计学差异(P>0.05)。膝以下小动脉(胫前动脉发出点及其以下血管)病变中,DM组的斑块检出率明显高于HP组(P<0.05),且主要以硬斑为主,后者则以少量软斑为主;病变狭窄程度积分,DM组为左侧:7.96±3.10,右侧:8.30±2.48;HP组为左侧:3.27±1.66,右侧:3.34±1.42,两组有统计学差异(P<0.05)。结论糖尿病患者并发下肢动脉硬化闭塞症较单纯高血压患者严重,以膝下终末血管受累明显,且以弥漫性硬斑为主。
Objective To investigate the pathological changes of lower extremity arteriosclerosis obliterans in patients with diabetes mellitus using 64-slice CT angiography (CTA). Materials and Methods 62 patients with clinically diagnosed lower extremity arterial arterial occlusive disease were divided into diabetic group (DM) and simple hypertension group (HP) according to the presence or absence of diabetes mellitus (33 cases and 29 cases). CTA examination of lower extremity arteries using 64-slice spiral CT was performed. The lower extremity arteries were divided into 12 segments using arteriography 12-segment integration method. The plaque distribution (plaque detection rate) and plaque Nature and, respectively, of the various segments of the degree of stenosis for comparative analysis. Results There was no significant difference in the detection rate of plaque between the two groups (P> 0.05), and all of them were mainly mixed plaque. The arterial lesion stenosis score The left side of the DM group: 6.51 ± 3.47, the right side: 6.96 ± 3.08; the left side of the HP group: 4.86 ± 2.06, the right side: 5.34 ± 2.02. There was no statistical difference between the two groups (P> 0.05). In the lesion of the knee below the lesion, the plaque detection rate in DM group was significantly higher than that in HP group (P <0.05) Soft spot; the degree of lesion stenosis, DM group was left: 7.96 ± 3.10, right: 8.30 ± 2.48; HP group was left: 3.27 ± 1.66, right: 3.34 ± 1.42, there was a significant difference between the two groups (P <0.05). Conclusion Diabetic patients with arteriosclerosis obliterans lower extremity arteriosclerosis than patients with severe hypertension, knee terminal vascular involvement was obvious, and mainly diffuse hard spot.