冠心病合并2型糖尿病患者的临床及冠脉病变特点

Clinical and Angiographic Characteristics of Patients with Coronary Heart Disease Complicated with Type 2 Diabetes

目的 总结冠心病合并 2型糖尿病患者的临床及冠脉病变特点 ,以增强对这些患者的防治意识。方法 分析 10 6例冠心病合并 2型糖尿病患者和 4 5 0例未合并 2型糖尿病的冠心病患者的危险因素、血脂及冠状动脉造影结果 ,比较两组患者临床及冠脉病变的差别。结果 与未合并 2型糖尿病的冠心病患者相比 ,冠心病合并 2型糖尿病患者的女性偏多 ,体重指数明显增加 ,高血压及血脂异常发生率显著增高 ;甘油三酯及载脂蛋白B显著升高 ,高密度脂蛋白胆固醇则明显降低。这些患者的多支血管病变明显增多 (72 6 4 %对 5 6 % ,P =0 0 0 2 ) ,Gensini积分也明显增加 (5 9 3± 35 85对 4 9 37± 37 5 4 ,P =0 0 14 )。结论 冠心病合并 2型糖尿病患者的女性偏多 ,更易合并其他危险因素 ,其血脂异常特点为高甘油三酯血症和低高密度脂蛋白胆固醇血症 ,冠脉病变特点以多血管病变多见 。

Objective To summarize the clinical and angiographic characteristics of patients with coronary heart disease (CHD)complicated with type 2 diabetes.Methods 106 patients with CHD complicated with type 2 diabetes and 450 patients not complicated with type 2 diabetes were studied by case-control methods, whose risk factors, blood lipids and coronary angiogram were analyzed.Results Compared with patients with CHD not complicated with type 2 diabetes, more female patients were found in patients complicated with type 2 diabetes, the prevalence of hypertension and dyslipidemia was significantly higher. Blood triglyceride concentrations was raised, while blood high density lipoprorein-cholesterol concentrations was decreased. More multi-vessel diseases[72.64%v.s 56%,P=0.002] were found in patients with CHD complicated with diabetes, whose Gensini scoring was significantly increased(59.3±35.85 v.s 49.37±37.54,P=0.014).Conclusion The CHD patients complicated with type 2 diabetes are more female,and easily clustering risk factors, whose coronary lesion is more severe.