冠心病患者糖代谢异常的发生及其与冠状动脉病变程度的相关性

Prevalence of glucose metabolism disorders in patients with coronary artery disease and the correlation between coronary artery lesions and glucose metabolism status

目的通过测定既往无糖尿病史的冠心病患者的空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbAlC）水平，评估冠心病患者糖代谢异常的发病率，并探讨冠状动脉病变程度与糖代谢异常的相关性。方法选取符合标准的冠心病患者152例，根据冠状动脉造影结果分为单支、二支及三支病变组，同期另择非冠心病患者50例作为对照组。测定比较各组对象FPG、2hPG以及HbAlC水平，并分析不同冠状动脉病变与血糖的相关性。结果正常对照组与单支病变组2hPG及HbAlC水平无明显差异（P〈0.05）；二支及三支病变组2hPG、HbAlC水平均明显高于正常对照组和单支病变组（均P〈0.05）。血糖正常者84例，糖调节受损32例，糖尿病36例，糖代谢异常发生率为44.7％。随着冠状动脉病变程度的加重，各组间糖代谢异常发生率逐渐增高，两两比较差异均有统计学意义（均P〈0.05）。同样，随着糖代谢异常程度的加重，多支病变率（二支及三支病变）也逐渐增加。糖代谢异常的冠心病患者较糖代谢正常的冠心病患者差异具有显著性（P〈0.05）。冠状动脉病变支数与FPG、2hPG、HbAlC均呈显著正相关（均P〈0.01）。结论冠心病患者糖代谢异常的发生率较高。糖调节受损的患者多支病变率、弥漫性病变程度与糖尿病患者相似。应加强糖调节受损人群的早期发现及干预，防止或延缓糖尿病大血管并发症的发生、发展。

Objective To evaluate the prevalence of gtucose metabolism disorders in patients with coronary artery disease （CAD） and to investigate the correlation between coronary artery lesions and glucose metabolism status. Methods Total 152 CAD patients were enrolled in the study; according to findings of coronary artery angiography patients were classified as singlebranch lesion, double-branch lesion and three-branch lesion. Fifty non-CAD patients served as controls. The fasting plasma glucose （FPG）, 2-hour plasma glucose （2hPG） and hemoglobin Alc （HbAlC） levels were measured in CAD and non-CAD groups. Results There were no significant differences in 2hPG and HbAlC between single-branch lesion and control groups （P〉 0.05）; but 2hPG and HbAlC of double-branch lesion and three-branch lesion groups were significantly higher than those of sin- gle-branch lesion and control groups （P〈 0.05）. Among 152 patients 84 had the normal plasma glucose levels, 32 had impaired plasma glucose regulation and 36 had diabetes mellitus; the prevalence rate of glucose metabolism disorders was 44.7% （68/152）. The prevalence of glucose metabolism disorders in CAD patients with double and three-branch lesion was higher （P〈 0.05）; and the number of coronary lesions was significantly correlated with FPG, 2hPG and HbAtc levels （P〈 0.01）, And also there were significant differences between normal glucose tolerance （NGT） group and impaired glucose tolerance （IGT） group （P〈 0.05）. Conclusion The prevalence of glucose metabolism disorders is higher in patients with CAD, and the prevalence of glucose metabolism disorders is correlated with the severity of coronary artery lesions.