冠状动脉侧支循环与糖尿病关系探讨

Relation between diabetes and coronary collateralcirculation

为探讨冠状动脉 (简称冠脉 )侧支循环形成与糖尿病的关系 ,将经冠脉造影证实至少一支冠脉血管直径狭窄≥ 75 %的 2 65例冠心病患者按有无糖尿病分成两组 ,再以 5 5岁为界分成 4个亚组 ,进行侧支循环开放情况比较。结果显示 ,冠脉开放率糖尿病组 (4 5 .7% )低于非糖尿病组 (69.2 % ) ,P<0 .0 5 ;其中 <5 5岁糖尿病组(69.2 % )高于非糖尿病组 (3 8.9% ) ,P<0 .0 1;≥ 5 5岁糖尿病组 (4 0 .4% )低于非糖尿病组 (67.2 % ) ,P<0 .0 1。提示冠心病患者冠脉侧支发展程度与糖尿病有关。整体上 ,糖尿病是冠脉侧支循环发展的不利因素 ,但在不同年龄段有很大差别 ,其抑制作用主要表现在≥ 5 5岁者 ,而 <5 5岁者的抑制作用不但不明显 。

To study the relation between diabetes and coronary collateral circulation.A cohort of 265 patients with ≥75% luminal diameter stenosis involving at least one major coronary artery was retrospectively analysed angiographic features and interaction between coronary artery stenosis,diabetes with coronary microcirculation.The patients were divided into two groups based on artery stenosis degree,then four subgroups on diabetes mellitus and age.The prevalence of collateral circulation in diabetes group was lower than nondiatetec group(45.7% vs 69.2% P<0.05).In man age <55 years,diabetes group's prevalence of collateral circulation was higher than nondiabetes group(69.2% vs 38.9%,P<0.01),and diabetes group's prevalence of collateral circulation in older group(≥55 years)was lower than nondiabetes group(40.4% vs 67.2% P<0.01).Diabetes mellitus has negative relation with collateral vessel formation.But in man age <55 years,diabetic patients with coronary artery disease develop more extensive coronary collateral circulation than nondiabetic subjects.