国际医学放射学杂志2025，Vol.48Issue(5)：504-508,534,6.DOI:10.19300/j.2025.L22297
冠状动脉CT血流储备分数对合并冠状动脉疾病的糖尿病病人预后的预测价值
Prognosis value of coronary CT-derived fractional flow reserve in diabetic patients with coronary artery disease
摘要
Abstract
Objective To evaluate the prognostic value of CT—derived fractional flow reserve(CT-FFR)for predicting major adverse cardiovascular events(MACE)in diabetic patients with coronary artery disease(CAD).Methods A total of 876 CAD patients with coronary stenosis ranging from 25％to 80％,who underwent coronary CT angiography(CCTA)and had complete follow-up data,were prospectively enrolled.The median follow-up time was 2.9 years.Among them,224 were diabetic and 652 were non-diabetic.Baseline clinical data were recorded,coronary stenosis severity was quantitatively assessed on CCTA,and CT-derived fractional flow reserve(CT-FFR)were measured for hemodynamic assessment.The primary clinical endpoint was MACE,including all-cause death,non-fatal myocardial infarction,and unplanned revascularization.The survival probabilities of diabetic patients and non-diabetic patients were analyzed respectively by the Kaplan-Meier method,and the survival differences between the two groups with CT-FFR ≤0.80 and CT-FFR＞0.80 were compared by the log-rank test.Univariate and multivariate Cox regression analyses were performed to identify independent predictors of MACE in diabetic and non-diabetic CAD patients.Results Compared with the non-diabetic group,the diabetic group had higher rates of hypertension,more patients with coronary stenosis severity ≥50％,and higher levels of fasting blood glucose,systolic and diastolic blood pressure,and triglycerides;conversely,high-density lipoprotein,total bilirubin,and direct bilirubin levels were lower in the diabetic group(all P＜0.05).Kaplan-Meier curve analysis showed that in both diabetic and non-diabetic patients,the survival probability of CT-FFR ≤0.80 group was lower than CT-FFR＞0.80 group(both P＜0.05).Univariate and multivariate Cox regression analysis identified CT-FF R ≤0.80 as an independent predictor of MACE in diabetic patients,whereas hyperlipidemia,coronary stenosis severity ≥50％,and CT-FFR ≤0.80 were independent predictors of MACE in non-diabetic patients.Conclusion CT-FFR can predict the 3-year occurrence of MACE in diabetic patients with CAD.关键词
体层摄影术,X线计算机/CT血管成像/CT血流储备分数/冠状动脉疾病/糖尿病Key words
Tomography,X-ray computed/Coronary computed tomography angiography/CT-derived fractional flow reserve/Coronary artery disease/Diabetes分类
医药卫生引用本文复制引用
吴诗瑶,梁泉,乔红艳,周长圣,钟健,张龙江,陈随,杨桂芬..冠状动脉CT血流储备分数对合并冠状动脉疾病的糖尿病病人预后的预测价值[J].国际医学放射学杂志,2025,48(5):504-508,534,6.基金项目
国家自然科学基金项目(82271992,82302187) （82271992,82302187）
