空腹血糖受损与冠状动脉病变的相关性研究

The relationship between the extent and severity of angiographic coronary artery disease and impaired fasting glucose

目的探讨糖尿病前期空腹血糖受损与冠状动脉病变程度的相关性。方法回顾分析630例拟诊冠心病（CHD）并行冠状动脉造影患者的临床资料，冠脉造影病变程度以是否诊断CHD、冠脉病变支数和冠脉病变Gensini总积分三方面表示；根据空腹血糖（FPG）水平将所有研究对象分为3组：A组FPG〈5．6mmol／L者297例；B组5．6mmol／L≤FPG〈6．1mmol／L者185例；C组6．1mmol／L≤FPG〈7．0mmol／L者148例。进行组间冠心病危险因素和冠脉病变程度比较，对FPG水平与冠脉病变程度进行单因素和多因素分析。结果（1）A组冠心病患病率为32．7％，单支病变50．5％、双支病变30．9％，多支病变18．6％，Gensini积分13．26±3．15，B组冠心病患病率为40．5％，单支病变42．7％、双支病变32．0％，多支病变25．3％，Gensini积分24．53±4．26，C组冠心病患病率为57．4％，单支病变30．6％、双支病变32．9％，多支病变36．5％，Gensini积分30．45±4．03，三组比较，随着FPG逐渐升高，冠心病患病率、冠脉病变积分、多支病变发生率逐渐升高（P〈0．05）；（2）FPG与冠状动脉病变支数（r=0．413；P〈0．05）、冠脉病变Gensini积分（r=0．492；P〈0．05）呈正相关；（3）多元逐步回归分析显示FPG与冠脉病变支数（β=0．327，P〈0．05）、冠脉病变总积分（β=0．281，P〈0．05）独立相关；（4）Logistic回归分析显示FPG为冠心病独立危险因素（OR=3．042，95％：2．589—6．275，P〈0．01）。结论糖尿病前期空腹血糖受损与冠状动脉粥样硬化密切相关，随着FPG升高，冠状动脉病变程度严重。

Objective To evaluate the correlation between impaired fasting glucose and the extent and severity of angiographic coronary artery disease（CAD） in patients who underwent coronary angiography. Methods A total of 630 consecutive patients who underwent coronary angiography were selected in the study. The extent and severity of angiographic CAD were diagnosed based on the followings：whether or not with CAD diagnosis by angiography, the number of diseased vessels, the CAD Gensini cumulative index. According to fasting plasma glucose （FPG）, all patients were divided into three group, group 1 （FPG 〈 5.6 mmol/L）, group 2 （5.6 mmol/L~〈FPG 〈6. 1 mmol/L） and group 3 （6. 1 mmol/L≤FPG 〈7.0 mmo]/L）. The CHD risk factors and the lesion degree of coronary arteries were compared among three groups. The relation of FPG and CAD were analyzed by univariate and multivariate analyses. Results The incidence of CH and, the CAD Gensini cumulative index and the incidence of muh-vessel lesions were sig- nificantly different among the three subgroups （ all P 〈 0. 05 ）. After adjusting other influencing factors, there were significantly positive correlation between the number of diseased vessels and the CAD Gensini cumulative index and FPG（ P 〈0. 05）. The FPG had significant correlation with the diagnosis or not of CAD by angiography（ OR = 3. 042,95% CI ：2. 589 -6. 275, P 〈 0.01 ）. Conclusions In prediabetic period, the extent and severity of angiographic coronary artery disease have significant correlations with the impaired fasting glucose, and the extent and severity can increase along with the increasing FPG.