糖尿病对冠心病患者冠状动脉侧支循环形成及左室功能的影响

Effect of diabetes mellitus on formation of coronary collateral vessels and left ventricular ejection function in patients with coronary artery disease

目的 评价糖尿病 (DM)对冠状动脉侧支血管(CCVs)及左室功能的影响 .方法 选择 1995 - 0 8- 0 1/2 0 0 0 -10 - 30做过冠脉造影的 DM患者 (排除冠脉造影正常和狭窄程度 <75 %的病例 ) 2 12例为 DM组 ;另选择同期入院的 2 12例非糖尿病 (NDM)并至少有一支冠脉狭窄≥ 75 %的患者作为对照组 .根据 Rentrop分级方法对患者的侧支循环进行评分 .行左室造影测量左室射血分数 (L VEF) .结果 两组冠脉狭窄程度相似 ,但病变血管数目 DM组 (1.78± 0 .6 0 )个明显高于 NDM组 (1.43± 0 .6 2 ) ,P<0 .0 1.平均侧支评分 DM组为 (2 .32± 2 .11) ,DM组为 (2 .6 8± 2 .2 6 ) ,P<0 .0 1.左室射血分数 (L VEF) DM组为 (4 8± 2 7) %,明显低于 NDM组(6 1± 2 2 ) %,P<0 .0 1.结论 DM组较 NDM组侧支循环形成不良 ,左室射血分数偏低 ,说明 DM是冠脉侧循环形成的抑制因素 。

AIM To evaluate the effect of diabetes mellitus (DM) on coronary collateral vessels (CCVs) and left ventricular ejection function in patients with coronany heart disease. METHODS Of the patients who underwent coronary angiography (CAG) during the interval between August l,1995 and October 30,2000,in our hospital, a total of 212 patients (CAG is normal or severity of coronary artery stenosis<75% were excluded from the study) met the criteria for the DM group. For case control matching, 212 consecutive nondiabetetic patients who had≥1 diseased vessel with>75% stenosis were included in the control group. The CCVs were graded according to the Rentrop scoring system and left ventricular ejection fraction (LVEF) was calculated by left ventricular angiography (LVG). RESULTS The sevrity of coronary stenosis was similar in the two groups, but the mean number of diseased vessels was significantly higher in the DM patients (1.78±0.60) than in the NDM patients (1.43 ±0.62), P <0.01. The mean collateral score was (2.32 ±2.11) vessels in the DM group and (2.68±2.26) vessels in the control group ( P <0.01). The mean LVEF was (48±27)% in DM group, much lower than that in the control group (61±22)%, P <0.05. CONCLUSION Our findings suggest that CCVs development and LVEF is poorer in patients with DM than in patients without DM Thus. We can speculate that DM is an important factor affecting CCVs development and left ventricular ejection function.