冠心病合并2型糖尿病患者冠状动脉病变特征分析

Analysis of the Characteristics of Arterty in Coronary Heart Disease Patients with Type 2 Diabetes

目的 探讨冠心病合并2型糖尿病患者冠状动脉病变特征.方法 入选笔者医院2012年6月～ 2014年2月经冠状动脉造影诊断为冠心病的患者213例,根据是否合并2型糖尿病分为2型糖尿病组、非糖尿病组.统计患者入院基本临床资料,所有患者均检测空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）,根据冠状动脉狭窄直径≥50％累及左前降支（LAD）、左回旋支（LCX）、右冠状动脉（RCA）或左主干（LM）分为单支、双支（累及左主干为双支病变）及3支病变组.计量资料采用均数±标准差（x±s）表示,组间比较采用两独立样本t检验,计数资料采用率表示,组间比较用x2检验.结果 冠心病合并2型糖尿病组患者空腹血糖（FPG）比非糖尿病组明显升高（8.45±0.40mmol/L vs 5.61±0.13mmol/L,P＜0.001）,冠状动脉3支病变发生率更高（50.00％ vs 8.94％,P＜0.001）,单支病变、两支/左主干病变发生率低于非糖尿病组（24.4％ vs 48.8％,P＜0.001;25.6％ vs42.3％,P＜0.001）,冠状动脉病变部位更多累及前降支（92.2％ vs 82.1％,P=0.034）、左回旋支（68.9％ vs39.8％,P＜0.001）、右冠状动脉（64.4％ vs 39.0％,P＜0.001）,冠状动脉左主干病变并无统计学意义（7.8％ vs 2.4％,P=0.100）.结论 冠心病合并2型糖尿病患者冠状动脉病变更为广泛、严重,具有更高的致死风险.

Objective To explore the characteristics of arterty in coronary heart disease patients with type 2 diabetes（T2DM）. Methods Totally 213 patients were diagnosed coronary heart disease（CHD） by coronary angiogarphy from June 2012 to Feb 2014 in our hospital. Patients were divided into T2DM group （90 cases） or NDM group（ 123 cases） according to wether combined with T2DM. 213 patients diagnosed of CHD were studied basic clinical charaters, fasting blood glucose, total cholesterol （ TC ） , triglycerides （ TG）, high density lipoprotein cholesterol（ HDL - C ） and low density liporotein cholesterol（ LDL - C） were determined in all the patients. All patients were divided into 1 vessel lesions,2 vessels lesions or large main vessel lesions,3 vessels lesions groups according to senosis of major ves- sels≥50%. The quantitative data were expressed by x ＋ s and the qualitative data were expressed by rete. The quantitative data compari- son between the groups was used independent - samples t test. Results Compared with NDM group,the T2DM group was higher in FPG （ 8.45 ± 0. 40mmol/L vs 5.61 ± 0.13mmol/L, P 〈 0. 001 ） , 3 vessels of coronary lesions （ 50.00% vs 8.94% , P = 0. 000）, left anterior descending arteries （LAD） （92.2% vs 82.1%, P = 0. 034 ）, left circumflexcoronary artery （ LCX ） （ 68.9 % vs 39.8 %, P = 0. 000 ） and right coronary artery（RCA） （64.4% vs 39.0% , P = 0. 000）. Conclusion The coronary lesions of CHD combined with T2DM was more extensive and serious, has high risk of death.