冠心病合并糖代谢异常冠脉病变特点及其危险因素分析

Analysis the risk factors of coronary heart disease and clinical characters of coronary angiography in patients with abnormal glucose metabolism

目的:探讨糖代谢异常冠状动脉病变特点和冠心病的危险因素。方法:74例拟诊冠心病患者行冠脉造影(CAG),57例空腹血糖正常者行口服葡萄糖耐量试验(OGTT)检查。根据CAG结果分冠心病组(CAD)、非冠心病组(非CAD),分析危险因素的差异;冠心病组分为糖尿病组(DM)、糖调节受损组(IGR)、正常血糖组(NGT),观察冠状动脉病变的特点。结果:糖代谢异常在冠心病与非冠心病差异有统计学意义(χ2值为6.14,P<0.05)。冠心病IGR组和DM组多支病变患病率,分别75%和50%,NGT组单支病变患病率55.6%,重度病变患病率DM组80%,NGT组77.8%。男性、DM、IGR、吸烟、危险因素累计数在CAD组与非CAD组差异有统计学意义(P<0.01)。结论:冠心病合并糖代谢异常患病率高,48.6%通过OGTT诊断,OGTT应列为心血管病的常规检查;冠心病合并糖尿病和糖调节受损病变以多支病变为主,病变重而弥漫,正常血糖以单支病变多见,病变重而局限。

Objective： To analysis the risk factors of coronary heart disease and the clinical characters of coronary angiography in the patients who suffered with abnormal glucose metabolism. Methods： 74 cases of patients who were preliminary diagnosed to coronary heart disease accepted coronary angiography （CAG）, 57 of them with normal fast blood glucose accepted the oral glucose tolerance test （OGTT）. All the patients were divided into the CAD group and without CAD group according to the results of CAG. The CAD divided into three groups （DM, IGR and NGT） was compared with the difference of the clinical characters of coronary lesions. Results： The prevalence of abnormal glucose metabolism was 64% in patient with CAD. The prevalence of abnormal glucose metabolism in CAD was significantly higher than that of without CAD（was 6.14, P〈0.05））. The coronary multivessel changes were more frequent in the IGR group and in the DM group than the NGT group （75%,50% vs. 16.7%）. The cor- onary single changes were more frequent in the NGT group than others. Compared with without CAD group, the CAD group showed significantly difference in the male, the prevalence of patients the DM and the IGR, the preva- lence of smoking and the total of risk factors （P〈0.01）. Conclusion： The coronary heart disease complicated with abnormal glucose metabolism and a high morbidity in patients, among these 46.8%was found through OGTT. We suggest that the OGTT should be classified as the routine examination of cardiovascular disease. Mainly for the multi artery diseases and the artery diseases is extensive and grave. Single artery diseases are more frequent in nor mal group and the artery diseases are grave and limited.