Predictive Value of CT Angiography Combined with Blood Lipid Level in Diabetes Mellitus with Coronary Artery Disease
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摘要: 目的：探讨CT血管造影（CTA）联合血脂水平诊断糖尿病合并冠脉病变的价值。方法：回顾性分析73例2型糖尿病（T2DM）患者临床资料，其中38例合并冠脉病变（T2DM-CHD组），35例无冠脉病变（T2DM组）。所有患者均常规检测血脂水平，并行冠脉CTA检查。以CAG检测结果为准，分析CTA联合血脂水平预测T2DM合并冠脉病变的价值。结果：血脂TC、TG、LDL-C随着冠脉病变的发生和程度加重而逐渐增高（P<0.05），HDL-C则逐渐降低（P<0.05）。CTA诊断T2DM合并冠脉病变与CAG一致性较高（Kappa值=0.752，P=0.000）。联合血脂和CTA检查明显提高诊断T2DM合并冠脉病变的灵敏度、特异度、阳性预测值和阴性预测值，分别达92.31%、95.15%、95.34%和96.37%。结论：CTA检测有助于预测CHD的发生和严重程度，CTA联合血脂水平可提高对T2DM合并冠脉病变的检出效能。Abstract: Objective:To explore the value of CT angiography(CTA) combined with blood lipid level in the diagnosis of diabetes mellitus complicated with coronary artery disease. Methods:The clinical data of 73 patients with type 2 diabetes mellitus(T2DM) were retrospectively analyzed, including 38 patients with coronary artery disease(T2DM-CHD group) and 35 patients without coronary artery disease(T2DM group). All patients were routinely tested for blood lipid level, and coronary CTA was performed. Based on the results of CAG, the value of CTA combined with blood lipid level in predicting coronary artery lesions in patients with T2DM was analyzed. Result:TC, TG and LDL-C increased gradually with the occurrence and severity of coronary artery disease(P<0.05), while HDL-C decreased gradually(P<0.05). CTA had a high consistency with CAG in the diagnosis of coronary artery lesions in patients with T2DM(Kappa value=0.752, P=0.000). The sensitivity, specificity, positive predictive value and negative predictive value of combined lipid and CTA examination were significantly higher than those of single lipid and CTA diagnosis, which were 92.31%, 95.15%, 95.34% and 96.37% respectively. Conclusion:CTA detection is helpful to predict the occurrence and severity of CHD, and combined with blood lipid level can improve the detection efficiency of coronary artery lesions in patients with T2DM.
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