老年糖尿病合并冠心病的病理与临床

Coronary heart disease in diabetic elderly:A pathological and clinical correlative study

老年糖尿病与老年非糖尿病的尸检各 4 0例。以冠状动脉狭窄指数 (SI)≥ 9为病理诊断冠心病的标准。①SI≥ 9,糖尿病组 2 7例 (6 7 5 % ) ,非糖尿病组 12例 (30 % )。②冠状动脉三支狭窄 3级以上 ,糖尿病组 18例 (45 % ) ,非糖尿病组 8例 (2 0 % )。③糖尿病组心肌梗死 18例 (45 % ) ,非糖尿病组 5例 (12 5 % )。④糖尿病组 ,高血压 2 6例 ,SI≥ 9达 2 0例 ,无高血压 14例 ,SI≥ 9仅 6例。⑤糖尿病组心肌微小动脉内膜肥厚是非糖尿病组的 2倍 ,血管周围纤维灶是非糖尿病组 4倍 ,坏死灶是非糖尿病组 2倍。

Stenotic index over 9(SI≥9) is taken as the pathological criterion for the diagnosis of coronary heart diabetic.40 diabetic elderly and 40 non diabetic elderly autopsied.①There were 27 cases with SI≥9 in 40 autopsied diabetic elderly(67.5%),12 in 40 non diabetic elderly(30%).②The 3 branches stenosis over G3 in 18 diabetic cases(45%),8 non diabetic cases(20%).③In the 40 diabetic cases,18 cases had MI(45%),while in 40 non diabetic elderly only 5 had MI(12.5%).④In the diabetic elderly group,26 cases had hypertensin,20 of them had SI≥9(76.9%),in 14 cases without hypertension,6 had SI≥9(42.8%).⑤Histopathologically in the diabetic group intramyocardial focal fibrosis and vascular inlimal hypertrophy were respectively 2 and 4 times more than those in non diabetic group.