| 韩莹,敖梦,王志刚.颈动脉粥样硬化斑块三维超声参数评估2型糖尿病患者冠心病风险[J].中国医学影像技术,2024,40(9):1332~1335 |
| 颈动脉粥样硬化斑块三维超声参数评估2型糖尿病患者冠心病风险 |
| Three-dimensional ultrasound parameters of carotid atherosclerotic plaque for evaluating risk of coronary heart disease in patients with type 2 diabetes mellitus |
| 投稿时间：2023-12-25 修订日期：2024-04-12 |
| DOI：10.13929/j.issn.1003-3289.2024.09.012 |
| 中文关键词: 糖尿病,2型 糖尿病并发症 冠心病 颈动脉狭窄 超声检查 前瞻性研究 |
| 英文关键词:diabetes mellitus, type 2 diabetes complications coronary disease carotid stenosis ultrasonography prospective studies |
| 基金项目:重庆市中青年医学高端人才项目。 |
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| 中文摘要: |
| 目的 观察颈动脉粥样硬化斑块三维(3D)超声容积参数预测2型糖尿病(T2DM)患者冠心病风险的价值。方法 前瞻性纳入88例T2DM合并颈动脉粥样硬化斑块患者,根据冠状动脉造影结果将其分为冠心病组(n=56)及非冠心病组(n=32)。记录临床资料、颈动脉粥样硬化斑块二维(2D)及3D超声容积结果,比较组间基本资料及超声参数,以多因素logistic回归分析筛选T2DM患者发生冠心病的独立预测因素,绘制受试者工作特征曲线,以曲线下面积(AUC)比较颈动脉粥样硬化斑块超声参数预测T2DM患者发生冠心病风险的效能。结果 相比非冠心病组,冠心病组T2DM病程、糖化血红蛋白及低密度脂蛋白(LDL)水平均较高,颈动脉粥样硬化斑块体积较大而灰度中位数(GSM)较低(P均＜0.05)。颈动脉粥样硬化斑块体积、GSM、T2DM病程及LDL水平为T2DM患者发生冠心病的预测因素(P均＜0.05);斑块体积、GSM及二者联合的AUC分别为0.864、0.828及0.927,且二者联合预测效能高于单一因素(P均＜0.05)。结论 以3D超声容积成像获取的颈动脉粥样硬化斑块体积及GSM均可间接反映T2DM患者罹患冠心病风险;二者联合预测冠心病风险的效能更高。 |
| 英文摘要: |
| Objective To observe the value of three-dimensional (3D) ultrasound volumetric parameters of carotid atherosclerotic plaque for evaluating the risk of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM). Methods Totally 88 T2DM patients with carotid atherosclerotic plaque were prospectively enrolled and divided into CHD group (n=56) and non-CHD group (n=32) according to results of coronary artery angiography. Clinical data, two-dimensional (2D) and 3D ultrasonic findings of carotid atherosclerotic plaques were collected and compared between groups. The independent predictors of CHD in T2DM patients were screened with multivariate logistic regression. Then the receiver operating characteristic curves of 3D volumetric parameters of carotid atherosclerotic plaque were drawn, the areas under the curve (AUC) were calculated, and efficacy for predicting the risk of CHD in T2DM patients were evaluated and compared. Results Compared with patients in non-CHD group, T2DM patients in CHD group had longer diabetes duration, higher glycosylated hemoglobin and low density lipoprotein (LDL), as well as bigger carotid atherosclerotic plaque volume and lower grayscale median (GSM) (all P＜0.05). Along with diabetes duration and LDL, the volume and GSM of carotid atherosclerotic plaque were also the predictive factors for CHD in T2DM patients (all P＜0.05). AUC of volume and GSM of carotid atherosclerotic plaque and the combination of them was 0.864, 0.828 and 0.927, respectively, and of the combination was higher than each alone (all P＜0.05). Conclusion The volume and GSM of carotid atherosclerotic plaque obtained with 3D ultrasound could indirectly reflect the risk of CHD in T2DM patients. Combination of these two parameters was more effective for predicting the risk of CHD. |
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