代谢综合征对糖尿病和非糖尿病患者冠状动脉血管病变的影响

The relationship between metabolic syndrome and severity of coronary stenosis in non-Diabetic and diabetic patients

目的:已有研究显示,代谢综合征(MS)和冠心病(CAD)的关系密切,本研究旨在探讨MS对糖尿病或非糖尿病患者冠状动脉病变狭窄程度的影响。方法:选择2008年3月至2010年9月,在北京安贞医院特需医疗科住院,行冠状动脉造影的634例患者。根据冠状动脉造影结果进行冠状动脉狭窄程度的评估,按冠状动脉病变支数分为单支病变、双支病变和多支病变。根据患者有代谢综合征指标的数目分成4组(0/1,2,3,4/5),比较各组对糖尿病或非糖尿病患者的冠状动脉病变情况的影响。结果:①MS患者(394例)与无MS患者比较(240例),CAD发病率增高(61.9%vs.30.8%,P<0.001),多支病变发病率增高(35.0%vs.15.0%,P<0.001),急性冠状动脉综合征发病率增高(50.0%vs.26.6%,P<0.001)。②非糖尿病组患者冠状动脉积分(冠状动脉病变程度)随着MS指标数目的增加而增加,差异有统计学意义(P<0.001);而在糖尿病组冠状动脉病变程度与MS指标数目差异无统计学意义(P>0.05)。结论:在非糖尿病组患者中随着合并MS指标数目增加冠状动脉病变的严重程度、冠心病例数、多支血管病变例数增加。而在糖尿病组患者中这种作用被糖尿病对冠状动脉的影响而掩盖。

Objective：Metabolic syndrome has been reported to be closely related to cardio-vascular disease, the present study investigated the relationship between metabolic syndrome and severity of coronary ste- nosis in Non-Diabetic and Diabetic patients. Methods ：634 patients who underwent their first coronary angiogra- phy in Mar. 2008 to ,Sept. 2010 in Beijing An Zhen hospital. Patients were divided into four groups according to the number of MS components ： 0/1, 2, 3, and 4/5. A coronary atherosclerosis score was used to quantify the extent of atherosclerotic involvement. The relationship between the MS score and angiographic CAD severity or clinical presentation was compared between non-diabetic and diabetic subjects. Results：①Individuals with the MS （n -= 394 ） had a higher prevalence of CAD （61.9% vs 30. 8%, P 〈 0. 001 ）, multi-vessel disease （35.0% vs 15.0%, p 〈 O. 001 ）, and acute coronary syndromes （50. 0% vs 26.6%, P 〈0. 001 ） than those without the MS（ n = 240）. ②In the non-diabetic group, atherosclerosis score increased with the MS score （P 〈 0. 001）; whereas there was no significant difference in the diabetic group （P 〉 0. 05）. Conclusion：The MS score is related to CAD severity in non-diabetic patients but the association between the MS score and angio- graphic CAD severity may be obscured in the presence of diabetes.