2型糖尿病与冠状动脉病变程度的相关性及特点分析

The correlation and characteristic of coronary artery disease with Type 2 diabetes mellitus

目的探讨2型糖尿病患者冠心病发病特点及与冠状动脉病变程度的相天性分析。方法选择2007年4月至2010年5月行择期冠脉介入治疗的本院2型糖尿病患者124例，同时选择2008年4月至2010年5月所有行择期行冠脉介入治疗的非糖尿病患者680例作为对照组。结果糖尿病组的124例病患中．人均冠脉病变1．98处（246／124），非糖尿病组680例人均冠脉病变0.45（305／680）处。2型糖尿病组冠心病发病率、发生急性心肌梗死及陈旧性心梗均是非糖尿病组的2倍多．糖尿病组左主十病变比例高于非糖尿病组（P〈0．05），完全或次全闭塞、分又处病变及弥漫性病变明显高于非糖尿病组（P〈0．05），非糖尿病组以单支病变、双支病变为主，而糖尿病组以三支病变为主，两组间差异均有统计学意义。结论2型糖尿病的存在显著加重冠状动脉病变程度，冠状动脉的损害呈现弥漫性损害，发生心肌梗死事件多。有效地控制糖代谢紊乱．早期诊断及规范治疗，在干预冠状动脉粥样硬化发生和发展中具有重要意义。

Objective To explore the coronary lesion characteristics of Type 2 diabetic patients with coronary heart disease. Methods 124 cases of type 2 diabetes , hospitalized from April 2007 to May 2010, and 680 cases of non-diabetic inpatients from April 2008 to May 2010, were selected as subjects. All subjects were to be carried out percutaneous coronary intervention. Results The per capita coronary lesions in 124 cases of Type 2 diabetes and 680 cases of non-diabetic were 1.98（246/124）, 0.45（305/680） place/case, respectively. The incidence of coronary heart disease, acute and old myocardial infarction in the diabetic was twice and more higher than that of non-diabetic patients. The proportion of left main coronary artery lesions, total or subtotal occlusion, bifurcation and diffuse lesions in the diabetic were significantly higher than that of non-diabetic pa- tients （P〈0.05）. Significant difference fi＇onl the coronary lesions in the non-diabetic patients, which nlainly oc- curred in the single vessel or double, the diabetic principally focused on three vessels. Conclusion Type 2 dia- betes will remarkably aggravate the pathological lesions of coronary artery, leading diffuse lesions and increasing the incidence of myocardial infarction. So, early diagnosis and effective control of glucose metabolism disorder will help to prevent against coronary atherosclerosis.