冠心病合并2型糖尿病患者临床表现与冠状动脉造影结果分析

Clinical presentation and coronary angiographic characteristics in coronary heart disease patients with non-insulin-dependent diabetes mellitus

目的探讨冠心病(CHD)合并2型糖尿病(NIDDM)患者的临床表现和冠状动脉病变特点。方法对80例冠心病合并2型糖尿病患者及与之配对的非糖尿病冠心病患者进行临床表现和血管造影资料对照分析。结果冠心病合并2型糖尿病组与配对组比较,有高血压病史者分别占71.5%和45.3%(P<0.05),有高血脂者分别占68.7%和42.2%(P<0.05),冠心病合并2型糖尿病组与配对组的3支病变比例分别为35.0%和12.5%(P<0.05),病变血管比例分别为68.3%和55.8%(P<0.05),弥漫性病变血管比例分别为15.0%和5.8%(P<0.05)。两组的冠状动脉狭窄程度差异不明显(P>0.05)。结论冠心病合并2型糖尿病患者的高血压、高血脂比例较高,其冠状动脉血管的病变特点有别于无糖尿病的冠心病患者,3支病变比例和弥漫性病变血管比例高,血管受累支数多,在对冠心病合并2型糖尿病患者的诊疗过程中要充分考虑其病变特点。

Objective To explore the clinical presentation and coronary angiographical characteristics in coronary heart disease （CHD） patients with non-insulin-dependent diabetes mellitus （NIDDM）. Methods Fifty cases of CHD patients with NIDDM were matched with 50 other CHD patients without NIDDM. In the controlled study the clinical manifestation and the change of coronary angiography were carried out between the patients with and withoutNIDDM. Results The incidence of hypertension and hyperlipemia in NIDDM group were higher than those in control group （71.5% vs 45.3%, P〈0.05; 68.7% vs 42.2%, P〈0.05） In NIDDM group more tripe-vessels were involving （35.0% vs 12.5%, P〈0.05） , the coronary vessel lesion（68.3% vs55.8%, P〈0.05） and diffuse lesions （15.0% vs 5.8%, P〈0.05） were also higher , even though the change had similar degree of coronary artery stenosis（P〈0.05）. Conclusion In clinical diagnosis and treatment the CDH patients with NIDDM must be paid enough attention to distinctive feature as already described.