急性心肌梗死并发2型糖尿病临床及冠脉造影特点分析

Analysis of Coronary Angiography in Patients with Acute Myocardial Infarction and Type 2 Diabetes Mellitus

目的分析急性心肌梗死(AMI)并发2型糖尿病患者临床资料和冠状动脉病变特点。方法对2005年1月—2008年1月中日友好医院285例急性心肌梗死并行冠状动脉造影(CAG)检查的患者进行回顾性研究,分析临床资料、冠状动脉病变的特点。结果糖尿病患者占38.9%,AMI并发糖尿病组(DM组)患者、高血压、周围动脉硬化症和心肌梗死后行冠脉搭桥术的患者比例均明显高于非糖尿病组(NDM组,P<0.05);DM组三酰甘油(TG)明显高于NDM组,而高密度脂蛋白(HDL)明显低于NDM组(P<0.05)。造影结果分析:DM组冠状动脉总病变数、左主干病变、三支病变、C型病变和弥漫性病变均高于NDM组(P<0.05);而单支病变、A和B1型病变低于NDM组(P<0.05)。DM组右冠状动脉病变明显高于NDM组,而前降支病变、回旋支病变和心肌梗死部位的比较,两组无统计学意义(P>0.05)。结论急性心肌梗死并发2型糖尿病患者多并发肥胖、高血压、高脂血症,冠状动脉病变受累范围广,病变严重、弥漫。

Objective To evaluate the clinical data and coronary angiographic characteristics in patients （pts） with acute myocardial infarction （AMI） type 2 diabetes mellitus. Methods From January 2005 to January 2008 in China -Japan Friendship Hospital,285 pts with AMI who underwent selective percutaneous coronary intervention were analyzed retrospectively. Pts were divided into two groups：111 cases with type 2 diabetes mellitus and 174 cases with non-diabetic. Clinical features and coronary angiographic results were compared between the two groups. Results There were 38. 9% of the pts with diabetes. Diabetic pts were more often with obese,hypertension,hyperlipemia and peripheral arterial disease（P〈0.05）. The level of triglycerin （TG） in diabetic pts was much higher than that in non-diabetic pts,while the level of the high density lipoprotein cholesterol （HDL） was lower than that in non-diabetic respectively（P〈0.05）. The number of the pts who underwent coronary artery bypass grafting was higher than those with non- diabetic. Left main lesion, sever three-vessel lesions, type C lesions and diffuse lesions in diabetic patients were significantly more than that in non- diabetic group respectively （P〈0. 05）. Additionally,the total number of lesion was more common in diabetic pts. Diabetic pts were more often with right coronary artery diseases and less frequently single - vessel disease. Lesions, type A or B1 lesion in pts with diabetes were more than that in pts without diabetes（P〈0.05）. Conclusion Diabetic pts had more risk factors of coronary heart disease,and coronary lesion was more diffuse and severe.