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目的探讨老年冠心病(CAD)合并2型糖尿病(T2DM)患者冠状动脉CT血管成像(CTA)的成像特点。方法入选2012年10月至2013年10月冠状动脉造影检查确诊为CAD的老年患者640例,其中合并T2DM者350例,无合并T2DM者290例,冠状动脉造影后2周内行新双源flash-CT冠脉成像,分析老年CAD合并T2DM患者冠状动脉CTA的诊断特点。结果新双源flash-CT冠状动脉CTA对T2DM合并CAD患者冠状动脉病变的诊断特异性为89.6%。CAD合并T2DM患者冠状动脉钙化较严重,病变支数多,随着钙化积分的增高,特异性有所下降,但CTA对于介入治疗仍有指导作用。结论新双源flash-CT冠状动脉CTA是诊断老年CAD合并T2DM患者冠状动脉病变可靠、无创的检查方法,但严重钙化者要结合冠脉造影结果进行综合判断。
Objective To investigate the imaging characteristics of coronary artery CT angiography (CTA) in elderly patients with coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM). Methods A total of 640 elderly patients diagnosed with coronary artery angiography from October 2012 to October 2013 were selected. Among them, 350 patients with T2DM and 290 patients without T2DM underwent coronary angiography within 2 weeks after coronary angiography. CT coronary angiography to analyze the diagnostic characteristics of coronary CTA in senile CAD patients with T2DM. Results The diagnostic specificity of new double-source flash-CT coronary CTA for coronary artery disease in T2DM patients with CAD was 89.6%. Coronary artery calcification was more severe in CAD patients with T2DM, with more lesions. With the increase of calcification score, the specificity decreased, but CTA still had a guiding role in interventional therapy. Conclusions The new double-source flash-CT coronary CTA is a reliable and noninvasive method to diagnose coronary artery disease in elderly patients with CAD and T2DM. However, severe calcifications should be combined with coronary angiography findings.