Asemptomatik Tip 2 Diyabetes Mellitus Tanılı Hastalarda Koroner Arterlerin 64-Dedektörlü Bilgisayarlı Tomografi İie Değerlendirilmesi

Yıl 2019, Cilt: 9 Sayı: 1, 74 - 79, 27.03.2019

Sadık Server Memduh Dursun Bülent Acunaş

https://doi.org/10.16899/gopctd.419200

Öz

Amaç:   Diyabetli hastalarda başlıca ölüm nedeni olan
koroner arter hastalığı (KAH)  hastaların
bir bölümünde sessiz seyreder. Bu çalışmanın amacı asemptomatik tip II diyabetli
hastalarda gizli KAH prevalansını, mevcut plakların yaygınlığını,
lokalizasyonunu ve özelliklerini çok kesitli bilgisayarlı tomografi anjiografi
(ÇKBTA) ile değerlendirmektir.

Gereç ve Yöntem: Tip II diyabet tanılı KAH açısından asemptomatik olan 100  hasta ÇKBTA ile prospektif değerlendirildi.
Kalsiyum skorlama amacıyla kontrastsız görüntüler elde edildikten sonra i.v.
kontrast madde verilerek 64 dedektörlü BT ile koroner anjiografik görüntüler
alındı. Kontrastsız görüntüler üzerinden koroner arter kalsiyum skoru
hesaplandı ve plakların kalsiyum içeriği incelendi. Koroner angiografik
görüntülerden elde edilen reformat görüntülerden ise plakların yaygınlığı,
lokalizasyonu ve oluşturdukları darlık dereceleri değerlendirildi.  Kategorik değişkenlerin istatistiksel
değerlendirilmesinde Pearson ki-kare testi ve Fisher gerçeklik testi
kullanıldı.

Bulgular: Çalışmaya dahil edilen 80 hastanın
%72’si erkek (n=58) ve %27’si (n=22) kadındı. Ortalama yaşları 53±8 ve çekim
esnasında kalp hızları ise 64±7 idi. 49 hastada (%61)
aterosklerotik plak saptandı; Kalsifik plak en çok saptanan aterosklerotik plak
tipiydi (%35), soft plak 9 (%11.3) hastanın en az bir koroner arter segmentinde
saptandı. 14 (%17.5) hastada orta darlık, 11 (%13.7) hastada ciddi darlık  ve böylelikle 25 (%31.3) hastada anlamlı
darlık (≥ %50) saptandı. Tek damar hastalığı (19, %23.7), iki damar hastalığı
(15, %18.7), üç damar hastalığı (15, %18.7) saptandı.

Sonuç: Diyabetli hastalarda asemptomatik KAH’ın ortaya konmasında
ÇKBTA noninvazif ve güvenilir bir yöntem olarak kullanılabilir

Anahtar Kelimeler

diyabetes mellitus, koroner arter hastalığı

Kaynakça

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