2型糖尿病患者病程及血糖水平对冠状动脉病变的影响

Effect of Disease Course and Blood Glucose on the Analysis of Coronary Arteriography in Patient with Type 2 Diabetes

目的:探讨不同发病年限及不同血糖对糖尿病合并冠心病的冠状造影分析。方法:对确诊的2型糖尿病冠心病患者120例,依据配对要求,除糖尿病因素及发病年限不同外,对所有研究对象记录的其他条件包括性别、年龄、体重、血压、血脂、吸烟等相同,按发病年限及血糖控制满意与否分组进行分析;冠状动脉造影过程用数码光盘记录,以每支血管的多角度影像的平均值作为该血管的狭窄程度结果。结果:在糖尿病合并冠心病组中,5年以下的糖尿病组中,血糖控制满意组与对照组之间没有统计学意义,血糖控制不满意组与对照组之间有显著性差异;5年以上的糖尿病组中,实验组与对照组相比,都有显著性差异。5年以上糖尿病组与5年以下糖尿病组相比,5年以下病例3支病变发生率为11%,5年以上糖尿病组3支病变发生率为48%,两组间异性有统计学意义(P<0.01);5年以下病例B型及C型病变发生率分别为34%和16%,5年以上糖尿病组B型及C型病变发生率分别为52%和38%,两组间差异性有统计学意义(P<0.01)。结论:血糖控制不满意及发病年限延长都会加重糖尿病合并冠心病冠状动脉的损伤。因此,认真控制血糖水平,早期发现糖尿病、早期防治糖尿病对预防糖尿病引起冠状动脉病变有积极的意义。

Objective： To investigate the different time occurrence of disease and different level of blood glucose on the analysis of coronary arteriongraphy in patient with diabetes and coronary herat disease. Methods： 120 patients with type 2 diabetes and coronary heart disease took part in this study, in which 60 patients whose disease duration is less than 5 years, while other 60 patients whose disease duration is between 5 and 10 years According to the requirement of analysis, the time occurrenco of disease and the level of blood glucose are different, but other factors＇ such ad sex, age, weight , blood pressure, blood cholesterol, smoking habit are same. In the resrareh, Coronary arteriography is recorded by digital disk, and the average value of arteriography from multiple angle is used to gauge the straitness of the blood vessel, After experiencing coronary arteriography, they were di- vided into groups based on occurrence of disease and their satisfactory or not. Results： In groups with diabetes and coronary heart disease and disease duration less than 5 years, there is no statistic difference between satisfied blood glucose controlled group and control group, but the difference between unsatisfied blood glucose controlled group and control group is great （P 〈 0.01）. In the groups disease duration longer than 5 years, the difference between experiment and control group is also significant （ P 〈 0.01 ）. Compared with 48 percent in groups with disease duration longer than 5 years, the occurrence of multi - vessel disease is 11 percent in the group with disease duration less than 5 years. The occurrence of B - type and C- type disease in the group with disease duration less than 5 years is 34 and 16 percent, respectively, on the while, The occurrence of B - type and C- type disease in the group with disease duration longer than 5 years is 52 and 38 percent, respectively. Conclusions： Both unsatisfied blood glucose control and longer disease duration should induce the damage of coronary artery in patients with diabetes and coronary heart disease. Satisfied blood glucose control, early diagnose and treatment of diabetes should be helpful in reducing the damage of coronary artery in diabetes patients.