冠心病合并2型糖尿病的冠脉病变特征及危险因素分析

Research on the Coronary Artery Lesion Characteristics and Risk Factors on Patients of Coronary Artery Disease with Type 2 Diabetes Mellitus

目的:探讨冠心病合并2型糖尿病的冠状动脉病变特征及其相关危险因素。方法:选择2010年1月至2012年1月我院经冠状动脉造影确诊为冠心病合并2型糖尿病的患者227例(DM组)和同期不合并2型糖尿病的冠心病患者229例(NDM组)为研究对象,回顾性分析其血脂、血糖及冠状动脉造影结果,比较两组患者冠状动脉病变的特点,探讨血糖水平对糖尿病合并冠心病患者冠状动脉病变的影响。结果:DM组患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)显著高于NDM组(P<0.05),高密度脂蛋白胆固醇(HDL-C)显著低于NDM组(P<0.05);DM组患者三支血管病变、弥漫性病变以及狭窄程度大于75%的血管的病例数百分率显著高于NDM组(P<0.05);在DM患者中,血糖水平控制理想组(A组)的冠状动脉血管狭窄程度大于75%以及发生弥漫性病变的病例数百分率均显著低于血糖控制较差组(B组,P<0.05)。结论:2型糖尿病合并冠心病患者冠状动脉多表现为弥漫和多支病变,狭窄程度严重;血糖和血脂水平异常是其冠脉病变的危险因素;控制患者的血糖水平于正常范围可改善其冠状动脉病变程度并减小其病变范围。

Objective： To discuss the clinical features and risk factors of coronary heart disease with type 2 diabetes. Methods： From January 2010 to January 2012, the patients who were diagnosed as coronary heart disease with （DM group： n=227） or without （NDM group： n=229） type 2 diabetes in our hospital by Coronary artery angiography were selected. The blood lipid, blood glucose and results of coronary angiography of the two groups were analyzed retrospectively, the clinical features of Coronary lesions of the two groups were compared, and the effect of blood glucose level on Coronary lesions in coronary heart disease patients with diabetes was investigated. Results： The total cholesterol （TC）, triacylglycerol （TG）, low density lipoprotein cholesterol （LDL-C） in DM group were significantly higher than those in the NDM group （P〈0.05）, but the high density lipoprotein cholesterol （HDL-C） was significantly lower than that in the NDM group （P〈0.05）; the number of triple vessel disease, diffuse vascular lesion and angiostegnosis of greater than 75% in DM group was more than those in the NDM group （P〈0.05）; the number of diffuse vascular lesion and angiostegnosis of greater than 75% in the group of blood glucose were controlled in a ideal level （group A） were significantly lower than those in the group of blood glucose w- ere controlled in a poor level （group B, P〈0.05） in coronary heart disease patients with type 2 diabetes. Conclusion： The clinical features of coronary angiography in coronary heart disease patients with type 2 diabetes were characteristic of diffuse and multivessel disease, the degrees of stenosis were severe. Both hyperglycaemia and dyslipidemia were the risk factors of coronary lesions; normalization of blood glucose could improve the severity of coronary lesions and decrease the range of lesions.