冠心病合并糖调节受损或2型糖尿病患者冠状动脉特点及介入术后的观察

The characteristics of coronary artery lesions and follow-up finding after stents implantation in patients with combined coronary heart disease and T2DM or IGR

目的对比分析冠心病(CHD)合并糖调节受损(IGR)或2型糖尿病(T2DM)患者冠状动脉特点及介入术后观察。方法选择CHD患者1212例,按WHO诊断标准分为血糖正常(NGT)组、空腹血糖受损(IFG)组、糖耐量受损(IGT)组及T2DM组,比较各组问冠状动脉病变程度及介入术后支架内再狭窄和晚期血栓的发生率。结果糖代谢异常各组在冠状动脉狭窄程度、病变范围、病变性质等方面的积分显著高于NGT组(P<0.05或P<0.01)。糖代谢异常患者支架内再狭窄率及T2DM患者晚期血栓形成率均显著增高(P<0.01)。结论 CHD合并IGR或T2DM患者,多个CHD危险因素并存,冠状动脉多支病变多见,病变程度严重、弥漫,且支架内再狭窄率及晚期支架内血栓形成率高。

Objective To study the characteristics of coronary artery and clinical outcomes after stents implantation in coronary heart disease（CHD）patients with type 2 diabetes or impaired glucose regulation（IGR）. Methods 1212 patients with CHD were enrolled and divided into NGT, IGT and T2DM group. Results OPrevalence rates of hypertension,high TG,low HDL-C, BMI≥25 were more frequent in group of IGR or T2DM compared with NGT group （P〈0.05 or P〈0. 01）. （2） The morbidity of T2DM and IGR was 72. 4%. OThe narrow severity score, the number of diseased vessels and scores of coronary artery lesion were more frequent in group of IGR and T2DM than NGT group. （4）The in-stent restenosis rates were more frequent in group of IGR and T2DM than in group of NGT. Late stent thrombosis rate was 2.35% in group of T2DM. Conclusions Coronar artery lesions of CHD patients with IGR and T2DM are more severe and many patients have multivessel lesions and diffuse vessel lesions. The in-stent restenosis rate and late stent thrombosis rate is higher in T2DM and IGR than in NGT group.