目的 探讨64排螺旋CT冠脉造影 (CTA)对2型糖尿病(T2DM)合并冠心病患 者冠脉狭窄的诊断价值。方法 回顾性 分析我院140例拟诊断冠心病的T2DM患 者的临床资料，所有患者均先后接受CTA 检查、选择性冠状动脉造影检查(CAG)。 以CAG为金标准，评价CTA筛查冠心病、 诊断病变血管以及管腔狭窄程度的灵敏 度、特异度、阳(阴)性预测值和Kappa值 (一致性)。结果 CTA筛查冠心病的灵敏 度为0.953，特异度为0.912，准确度为 0.943，阳性预测值为0.971，阴性预测 值为0.861，Kappa值为0.848，CTA与CAG 具有较好的一致性；CTA与CAG对左主干 (LM)病变诊断的一致性一般，对左前降支 (LAD)、左回旋支(LCX)以及右冠状动脉 (RCA)病变诊断的一致性较好；CTA诊断对 轻、中、重度管腔狭窄均具有较高的灵敏 度。结论 CTA对于T2DM合并冠心病患者的 筛查具有较高的准确性，可精准判断血管 病变与其狭窄程度。

Objective To explore the diagnostic value of 64-slice spiral CT coronary angiography (CTA) in coronary stenosis in patients with type 2 diabetes mellitus (T2DM) complicated with coronary heart disease. Methods The clinical data of 140 patients with T2DM suspected as coronary heart disease in our hospital were retrospectively analyzed. All patients were given CTA and selective coronary arteriography (CAG). CAG was used as the gold standard to evaluate the sensitivity, specificity, positivity (negative) predictive value and Kappa value (consistency) of CTA in the screening of coronary heart disease, diseased vessels and luminal stenosis. Results The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Kappa value of CTA in the screening of coronary heart disease were 0.953, 0.912, 0.943, 0.971, 0.861 and 0.848 respectively, and CTA had good consistency with CAG. The consistency of CTA and CAG was common in the diagnosis of left main artery (LM) lesions, and was good in the diagnosis of left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) lesions. CTA had high sensitivity in the diagnosis of mild, moderate and severe luminal stenosis. Conclusion CTA has high accuracy in the screening of patients with T2DM and coronary heart disease, and it can accurately determine the vascular lesions and stenosis degree.