糖尿病对老年冠状动脉粥样硬化性心脏病患者病程预后及脂质代谢的影响

Relativity between duration of type 2 diabetes mellitus and pathological changes of coronary heart disease

目的明确糖尿病对老年冠状动脉粥样硬化性心脏病（冠心病）患者病程预后及脂质代谢的影响。方法分析2008年1月-2011年6月在该院接受治疗的合并2型糖尿病的老年冠心病患者的临床资料,依据患者2型糖尿病病史分为3组,A组：〈5年;B组：5-10年;C组：〉5年。结果该研究共纳入研究对象117例,其中A组37例,B组42例,C组38例。随着糖尿病病程增加患者狭窄程度不断增加,而受累血管支数亦逐渐增加,相比较差异有统计学意义（P〈0.05）。随着糖尿病病程增加,患者血脂水平不断升高,3组比较差异有统计学意义（F=21.110,P〈0.001）。随着糖尿病病程增加患者出院后2年心血管不良事件的累积发生率显著增大,3组比较差异有统计学意义（Log-rankχ2=3.513,P=0.041）。结论合并2型糖尿病会加剧老年冠心病的病程进展,加剧脂质代谢紊乱。

[Objective] To analyze the relativity between duration of type 2 diabetes mellitus and patho- logical changes of coronary heart disease. [Methods] Clinical data of patients with coronary heart disease combine with type 2 diabetes mellitus received treatment at our hospital from 2008 to 2011 was analyzed. Patients were divided into 3 groups by course of disease ,Group A： 〈 5 years; Group B： 5 - 10 years; Group C： 〉 5 years. [Results] A total of 117 patients were analyzed, Group A 37, Group B 42, Group 38. With the increased duration of diabetes, the affected blood vessels counts were also increased gradually increasing degree of stenosis in patients with increased duration of diabetes （P 〈 0.05）. With the increased duration of di- abetes, the levels of blood fat were also increased gradually （F= 21.110, P〈0.001）. With the increased dura- tion of diabetes, the cumulative incidence of cardiovascular adverse events were also increased gradually （Log- rank X2 =3.513, P=0.041）. [Conclusion] Following the process of the diabetes, the coronary lesions in pa- tients with type 2 diabetes mellitus tend to be more widespread and severs.