冠状动脉造影对冠心病不同糖代谢状态患者冠脉病变特征的评价

Evaluation of coronary angiography in coronary heart disease and different status of glucose metabolism characteristics of coronary lesions

目的评价冠心病患者不同糖代谢状态与冠状动脉病变程度的相关性。方法选择经冠状动脉造影确诊的450例冠心病住院患者,依据不同糖代谢状态分为3组,即A组154例为正常血糖患者,B组149例为空腹血糖受损(IFG)患者,C组147例为糖尿病患者。所有患者均行选择性冠状动脉造影(CAG)检查,并对其冠脉病变特征进行分析。结果 3组患者临床资料比较,性别、年龄、吸烟情况、血脂水平及是否合并高血压情况差异均无统计学意义(P>0.05),其中空腹血浆葡萄糖水平(FBG)、糖化血红蛋白水平(Hb A1C)及体重指数(BMI),B组、C组分别与A组比较差异有统计学意义(P<0.05)。C组多支血管病变的比例明显高于A、B组(P<0.05),A、B 2组比较,差异无统计学意义;C组冠脉左主干狭窄及发生慢性闭塞性病变比例明显高于A、B 2组(P<0.05),A、B 2组比较差异无统计学意义;C组冠脉弥漫性病变及小血管病变发生比例明显高于A、B 2组(P<0.05),A、B 2组比较差异无统计学意义。结论冠心病合并糖尿病患者冠脉病变程度较非糖尿病患者更严重。

Objective To evaluate the features of coronary lesions in coronary heart disease （ CHD） patients with different gly？caemic status. Methods 450 patients with CHD which were confirmed by coronary angiography, were included in the study and divided into three groups according the different glycaemic status. Group A：normal glycaemic group （n=154）, Group B：patients with impaired fasting glucose （n=149） and Group C：diabetes mellitus patients （n=147）. Coronary angiography was performed and analyzed the fea？tures of coronary lesions in all of 450 patients. Results Group C had more multiple vessel lesions than group A and group B （ P 〈0. 01）, but there were no significant difference between group A and group B. Group C had more left main coronary lesions and chronic occlusive disease of coronary than group A、B（P〈0. 05）, but there were no significant difference between group A and group B. Group C had more diffused vessel lesions and small vessel lesions than group A and group B（P〈0. 05）, but there were no significant differ？ence between group A and group B. Conclusion More serious and complicated coronary lesions are found in coronary heart disease with diabetes mellitus.