老年冠心病合并2型糖尿病患者冠状动脉粥样硬化斑块钙化特征

Burden and features of calcified coronary atherosclerotic plaques in elderly patients with CHD accompanying diabetes mellitus

目的探讨老年冠心病合并2型糖尿病患者冠状动脉粥样硬化斑块钙化的总负荷和钙化特征。方法选择稳定性心绞痛患者72例,其中合并2型糖尿病40例(糖尿病组),无糖尿病32例(非糖尿病组)。均行冠状动脉造影,选取一处狭窄50%～70%的斑块进行血管内超声检查。测量斑块钙化弧面积,如果同一斑块内有多个钙化,分别测量每个钙化的弧面积,并将每个弧面积相加得到钙化总负荷,并记录每个斑块内钙化数量。结果与非糖尿病组比较,糖尿病组患者斑块钙化弧面积明显增大,钙化数量明显增多[(1343.0±1007.3)度×mm vs(707.7±589.0)度×mm,(2.4±2.0)个vs(1.4±1.3)个,P<0.05];糖尿病组与非糖尿病组每个钙化弧面积比较差异无统计学意义(P>0.05)。结论老年冠心病合并糖尿病患者冠状动脉钙化负荷更重,这种负荷的加重是由于斑块内钙化数量的增加所致,合并和不合并糖尿病的老年冠心病患者冠状动脉粥样硬化斑块钙化数量相同。

Objective To study the total burden and features of calcified coronary atherosclerotic plaques in elderly coronary heart disease（CHD） patients with diabetes mellitus（DM）. Methods Seventy-two elderly patients with stable angina pectoris were divided into DM group（n=40） and non-DM group（n=32）. The patients in two groups underwent coronary arteriography. A stenosis with 50%-70% plaques was selected to undergo intravascular uhrasonography. Arc area（AA） of calcified plaques was measured. AA of each calcified plaque was measured when several calcified plaques were found. Total burden of calcified plaques was obtained by adding each AA. The num- ber of calcifications in each plaque was counted. Results The total AA was larger and the number of calcified plaques was greater in DM group than in non-DM group（1343.0±1007.3 degree×mm vs 707.7±589.0 degree×mm,2.4±2.0 vs 1.4±1.3,P〈0.05）. However, no significant difference was found in AA of each calcified plaque between the two groups（P〉0.05）. Conclusion The burden of calcified coronary atherosclerotic plaques is greater in elderly CHD patients with DM than in those without DM, which increases with the increased number of calcified plaques. The number of calcified plaques is similar in elderly CHD patients with or without DM.