冠心病合并糖尿病与下肢血管动脉硬化关系的研究

Study on the Relationship between Diabetes Mellitus with Coronary Artery Disease and Lower Extremity Artery Atherosclerosis

目的:探讨下肢血管动脉硬化病变与冠心病和(或)糖尿病发生的关系及预测价值。方法:因心律失常、胸痛等症状入院的患者353例,根据有无冠心病和有无糖尿病分为糖尿病不合并冠心病组、糖尿病合并冠心病组、无糖尿病不合并冠心病组和无糖尿病合并冠心病组。于冠脉造影前进行下肢血管超声检查,观察斑块形成和血管内径(D)。结果:糖尿病患者较非糖尿病患者股动脉粥样硬化检出率增高,无糖尿病亦无冠心病患者股动脉斑块发生率极低,糖尿病不合并冠心病患者与冠心病不合并糖尿病患者下肢血管情况相似(P>0.05),斑块发生均明显高于无糖尿病亦无冠心病的患者(P<0.01),但明显低于糖尿病合并冠心病的患者(P<0.01或P<0.05),糖尿病合并冠心病患者其冠状动脉狭窄程度重,多为多支血管病变。结论:检测下肢血管动脉硬化斑块,对糖尿病和(或)冠心病患者冠状动脉硬化程度的预测具有重要意义。

Objective： To study the relationship between lower extremity artery atherosclerosis and the development of diabetes mellitus （DM） and or coronary artery disease （CAD）. Methods： Three hundred and fifty-three patients with chest pain and or arrhythmia were divided into four groups according to the diagnosis of CAD and DM. Before coronary angiogra- phy, vascular ultrasound was performed to detect plaque formation and vessel inner diameter （D）of the lower extremity arteries. Results： Compared with the patients without DM, those with DM had higher detection rate of femoral artery atherosclerosis. The incidence of femoral artery plaque was extremely low in subjects without DM or CAD. Vessel lesions were similar between patients only with DM and those only with CAD（P 〉 0.05 ）. The plaque incidences in these two groups were higher than that in group without DM or CAD （P 〈 0.01 ）. Patients with DM and CAD had severe coronaryartery lesions, and the majority were multi-vessel lesions. Conclusion：Extremity artery plaque may have certain predictive value for the severity of coronary artery lesions in patients with DM and or CAD.