青年冠脉综合征合并糖尿病患者临床特征及冠脉病变特点分析

Analysis of clinical features and coronary lesion characteristics in young patients with ACS complicated DM

目的:研究青年急性冠状动脉综合征(ACS)合并糖尿病(DM)患者的临床特征和冠脉病变特点。方法:选择于我院治疗的46例45岁以下ACS合并DM患者为ACS+DM组,同期于我院治疗的47例45岁以下ACS患者为ACS组。观察比较两组一般临床资料、临床生化指标、冠脉病变情况及术后30d主要不良心血管事件(MACE)发生率。结果:与ACS组比较,ACS+DM组超重/肥胖比例(70.2%比93.3%)、高血压比例(46.8%比71.7%),血脂指标:TC[4.3(3.8,5.0)mmol/L比5.3(4.1,6.4)mmol/L]、TG水平[1.8(1.2,2.4)mmol/L比2.7(1.9,3.8)mmol/L]、TG/HDL-C比值[2.1(1.3,2.9)比3.2(2.1,4.3)],冠脉多支病变比例(62.8%比84.8%)、冠脉Gensini评分[34.0(21.0,54.5)分比51.8(33.3,92.5)分]均显著升高(P<0.05或<0.01)。ACS+DM组术后30d MACE发生率显著高于ACS组(21.7%比6.4%,P=0.033)。结论:ACS合并DM显著升高青年患者超重/肥胖、血脂异常及高血压比例,加重冠脉病变,升高主要不良心血管事件发生率。

Objective:To study clinical features and coronary lesion characteristics in young patients with acute coronary syndrome(ACS)complicated diabetes mellitus(DM).Methods:A total of 46 ACS+DM patients(<45 years)treated in our hospital were selected as ACS+DM group.Another 47 ACS patients(<45 years)treated in our hospital were regarded as ACS group.General clinical data,clinical biochemical indexes,coronary artery lesions and incidence rate of major adverse cardiovascular events(MACE)within 30d after operation were observed and compared between two groups.Results:Compared with ACS groups,there were significant rise in percentages of overweight/obesity(70.2%vs.93.3%),hypertension(46.8%vs.71.7%),blood lipids indexes:levels of TC[4.3(3.8,5.0)mmol/L vs.5.3(4.1,6.4)mmol/L]and TG[1.8(1.2,2.4)mmol/L vs.2.7(1.9,3.8)mmol/L],and TG/HDL-C ratio[2.1(1.3,2.9)vs.3.2(2.1,4.3)];percentage of multivessel coronary disease(62.8%vs.84.8%)and coronary Gensini score[34.0(21.0,54.5)scores vs.51.8(33.3,92.5)scores]in ACS+DM group(P<0.05 or<0.01).Incidence rate of MACE within 30d after operation in ACS+DM group was significantly higher than that of ACS group(21.7%vs.6.4%,P=0.033).Conclusion:ACS complicated DM can significantly increase percentages of overweight/obesity,dyslipidemia and hypertension,aggravate coronary artery lesions,and increase incidence rate of major adverse cardiovascular events in young patients.