冠心病合并2型糖尿病女性患者冠状动脉造影特点分析

Anlysis of coronary angiography characteristics in female patients with type 2 diabetes mellitus with coronary heart disease

目的分析冠心病合并2型糖尿病女性患者冠状动脉造影特点及临床危险因素,探讨糖尿病对冠状动脉病变的作用机制。方法将2005年11月～2008年11月在我院经冠状动脉造影确诊为冠心病的女性患者168例,按有无2型糖尿病(DM)分为糖尿病组(DM组)和非糖尿病组(nonDM组),对其冠状动脉造影资料、危险因素进行分析研究。结果冠状动脉病变特点:冠状动脉受累血管及严重程度DM组比nonDM组显著高(P<0.01)。临床危险因素:收缩压、舒张压、空腹血糖(FBG)、餐后2 h血糖(2 hBG)、糖化血红蛋白(GHbA_1C)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)DM组比nonDM组高(P<0.05),且与冠状动脉狭窄程度呈正相关(P<0.05)。高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1_(ApoA_1)DM组比nonDM组显著低(P<0.01),且与冠状动脉狭窄程度呈负相关(P<0.05)。两组年龄、体重指数(BMI)差异无显著性(P>0.05)。结论冠心病合并2型糖尿病女性患者冠状动脉病变程度重,除糖尿病外,常与高血压、高血脂等危险因素同时存在。

Objective To analyze the clinical risk factors and characteristics of coronary angiography, to investigate the related in diabetes mellitus and coronary heart disease. Methods This study enrolled patients with CHD undergone coronary angiography from November 2005 to November 2008. A total of 168 female patients were divided into diabetes mellitus group（DM） and nondiabetes mellitus group （nonDM）. The clinical and angiography details were recorded and analyzed. Results Lesion of coronary artery and severe degrees are all significantly higher in diabetes mellitus group than in nondiabetes meltitus group （ P 〈 0.01）. The systolic pressure, dias- tolic pressure, fasting blood glucose （FBG）, 2 - hour blood glucose （2hBG）, glycosylation hemoglobin A1C（GH- bA1C ）, total cholesterol （ TC ）, triglycerides （ TG）, lower density lipoprotein cholesterol （ LDL - C ）, apolipoprotein B （APOB） are all significantly higher in diabetes mellitus group than in non - diabetes mellitus group （ P 〈 0. 05 ）, were positively correlated to coronary artery stenosis （ P 〈 0.05 ）. High density lipoprotein cholesterol （HDL- C）, apolipoprotein A1 （APOA1 ） are all significantly lower in diabetes mellitus group than that in nondiabetes mellitus group （ P 〈 O. O1 ）, were negatively related to coronary artery stenosis （ P 〈 0. 05）, Conclusion In female patients with diabetes mellitus, they have severe coronary artery lesions. Excluding diabetes mellitus, hypertension, high blood- fat, etc risky factors all simultaneously to exist.