付林 田路 刘秋美 郭建 张英

[摘要] 目的 探讨256层螺旋CT血管成像（CTA）在评价糖尿病患者和高血压患者下肢动脉硬化斑块病变的价值及对比分析。方法 回顾性分析2013年1月—2017年7月期间在该院256层螺旋CT行下肢动脉血管成像的56例糖尿病患者和70例高血压患者的临床及CT资料，采用双侧下肢动脉18节段分段法，对2组患者间动脉硬化斑块种类、血管狭窄程度、斑块病变范围等情况进行对比分析。结果 将糖尿病组患者下肢动脉血管共1 008节段，CT检出动脉粥样硬化672处（66.67%），高血压组共1 260节段，CT检出451处（35.79%），两组患者动脉粥样硬化的发生率差异有统计学意义（P<0.05）；两组患者动脉血管斑块均以混合斑块为主，糖尿病组斑块主要分布于腘动脉以下中小动脉且受累范围较弥漫，高血压组多分布于腘动脉以上大动脉，糖尿病组管腔轻度以上狭窄发生率高于高血压组（P<0.05）。结论 256层CTA在糖尿病患者下肢动脉粥样硬化斑块检出率高于高血压患者，糖尿病组斑块血管受累范围较弥漫、血管狭窄较严重，是导致下肢动脉栓塞的重要病因。

[关键词] 下肢动脉造影；动脉粥样硬化；糖尿病；高血压；MSCT

[中图分类号] R445 [文献标识码] A [文章编号] 1672-4062（2018）03（a）-0001-04

[Abstract] Objective To study the value and comparison of 256-slice CTA in treatment of lower extremity arterial plaque of patients with diabetes and hypertension. Methods The clinic CT data of 56 cases of diabetes patients and 70 cases of hypertension patients for 256-slice CTA lower extremity arterial plaque imaging in our hospital from January 2013 to July 2017 were retrospectively analyzed， and the atherosclerotic plaque type， angiostenosis degree and plaque lesion range were compared and analyzed by the 18 segmental segmental method of bilateral lower extremities artery. Results There were 1 008 lower extremity arteries in the diabetes group， 672 atherosclerosis（66.67%）was tested by CT， and there were 1 260 in the hypertension group， and 451（35.79%）was tested by CT， and the difference in the incidence rate of atherosclerosis between the two groups was obvious， with statistical significance（P<0.05）， and the mixed plaque was the main in the two groups， and the plaque was mainly distributed into the medium and small arteries below the popliteal artery， and the involved range was diffuse in the diabetes group， and great arteries above the popliteal artery in the hypertension group， and the incidence rate of stenosis slightly above the lumen in the diabetes group was higher than that in the hypertension group（P<0.05）. Conclusion The test rate of 256-slice CTA in treatment of lower extremity arterial plaque of patients with diabetes is higher than that of hypertension patients， and the plaque vascular involved range is diffuse， and the angiostenosis is severe， and it is a major cause of arterial embolism of the lower extremities.

[Key words] Arteriography of lower extremity； Atherosclerosis； Diabetes； Hypertension； MSCT

當今社会随着人们生活水平提高以及人口老龄化的加剧，糖尿病和高血压发病率逐年增高，且在世界范围内发病率逐年上升，2种疾病导致的并发症，如下肢动脉粥样硬化（动脉狭窄、闭塞等）的患者数目也明显增多[1]，因此医学界对下肢动脉粥样硬化的诊断、治疗方面越来越引起重视。随着高端CT的应用，其扫描速度快、层薄、强大的后处理重建功能及无创伤等优势，深受医生青睐，已逐渐成为下肢动脉造影的首选影像学检查方法[2-4]。该研究2013年1月—2017年7月通过对单纯糖尿病组和单纯高血压组患者的下肢动脉斑块检出、斑块性质、管径狭窄等情况作对比分析，探讨256层CTA在诊断下肢动脉硬化斑块病变的作用，并分析病变特征。现报道如下。……