2型糖尿病合并冠心病患者冠状动脉病变特征及其相关因素研究

The study of coronary angiography clinical features in patients with coronary heart disease andtype 2 diabetes mellitus

目的探讨2型糖尿病合并冠心病患者的冠状动脉（以下简称冠脉）病变特征及其相关因素。方法选取2007年12月一2011年5月在我院经冠脉造影证实为冠心病的患者共306例。按是否合并2型糖尿病分为合并2型糖尿病组（143例）及未合并2型糖尿病组（非糖尿病组，163例）。检测指标包括患者的病史、人体基本参数及代谢生化指标。所有患者均进行了床边心电图和冠状动脉造影检查。结果与非糖尿病组相比，2型糖尿病组患者空腹血糖、餐后2小时血糖、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、半胱胺酸蛋白酶抑制剂c、收缩压及舒张压明显升高（P均〈0．05），而胸痛症状的发生率明显降低（P〈0．01）。2型糖尿病组患者窦性心律失常发生率、室性心律失常发生率及传导阻滞发生率均明显升高（P〈0．05）。冠脉病变特征比较显示，2型糖尿病组单支冠脉病变发生率明显降低（P〈0．05），3支冠脉病变发生率明显升高（P〈0．01）。在受累血管病变程度的统计中，2型糖尿病组弥漫性病变发生率明显高于非糖尿病组（P〈0．01）。结论合并2型糖尿病的冠心病患者存在着病变更广泛而严重、代谢紊乱及合并症发生率更高的特征，具有更高的致死风险。

Objective To explore the characteristics of artery in coronary heart disease patients combined with type 2 diabetes （T2DM） and the related factors. Methods Three hundred and six cases of CHD confirmed by coronary angiography from Dec 2007 to May 2011 were recruited. Patients were divided into T2DM group（143 cases） or NDM group（ 163 cases） according to whether combined with T2DM. The inspecting indexes including the case history, anthropometic parameters, biochemical indexes. All patients take ECG examination and coronary angiography. Results Compared with NDM group, the FPG,2hPG, TC ,TG,LDL-C, Cys-C, systolic pressure and diastolic pressure in T2DM group were significantly higher （ All P 〈0.05） ,but incidence of chest pain were lower（ P 〈 0.01 ）. The cardiac dysrhythmias happened much more in DM group （P 〈 0.05 ）. According to the coronary angiography, the DM patients suffered much more from the extensive coronary areterythe lesions, especially multi-vessel lesions and diffuse le- sions,which are remarkably different from the control group（P 〈 0.01 ）. Conclusions Diffuse and complicated lesions of coronary arteries were more common in patients with coronary heart disease complicated with T2DM.