Clinical Characteristics and Coronary Angiographic Findings in Patients with Coronary Heart Disease and Type 2 Diabetes Mellitus

Objectives To study clini- cal and coronary angiographic findings in patients with both coronary heart diseases (CHD) and type 2 diabe- tes mellitus (T2DM). Methods 215 patients with CHD confirmed by coronary angiography were involved in this study. The patients were divided into two groups: 74 CHD patients with T2DM (mean age 64.7 ± 8.2 years, male/female 47/27), and 141 CHD pa- tients without T2DM ( mean age 66. 2 ±9. 2 years, male/female 100/41 ). The clinical features and the data from selective coronary angiographies were com- pared between type 2 diabetic and non - diabetic CHD patients. Results Compared to non - diabetic CHD patients, the patients with both CHD and T2DM suf- fered more from acute myocardial infarction, silent is- chemia and severe arrhythmias ( P < 0. 01, P < 0. 05 ) , and had higher serum triglycerides and apo - lipoprotein B, along with increased serum uric acid (P < 0. 01, P < 0.05), increased left ventricular end diastolic diameter ( P < 0. 01 ) , and decreased left ventricular ejection fraction ( P < 0. 001 ). Compared to non - diabetic CHD patients, the patients with both CHD and T2DM suffered more from triple vessel disease (P < 0. 01) , severe coronary artery stenosis, complete occlusions and diffuse lesions ( P < 0. 001). Conclusions Se- vere clinical manifestation, left ventricular dysfunction, diffuse or complicated lesions of coronary arteries weremore common in patients with both CHD and T2DM, it suggests that the type 2 diabetic CHD patients have poor prognosis.

Discovering hidden patterns:Association rules for cardiovascular diseases in type 2 diabetes mellitus

BACKGROUND It is increasingly common to find patients affected by a combination of type 2 diabetes mellitus(T2DM)and coronary artery disease(CAD),and studies are able to correlate their relationships with available biological and clinical evidence.The aim of the current study was to apply association rule mining(ARM)to discover whether there are consistent patterns of clinical features relevant to these diseases.ARM leverages clinical and laboratory data to the meaningful patterns for diabetic CAD by harnessing the power help of data-driven algorithms to optimise the decision-making in patient care.AIM To reinforce the evidence of the T2DM-CAD interplay and demonstrate the ability of ARM to provide new insights into multivariate pattern discovery.METHODS This cross-sectional study was conducted at the Department of Biochemistry in a specialized tertiary care centre in Delhi,involving a total of 300 consented subjects categorized into three groups:CAD with diabetes,CAD without diabetes,and healthy controls,with 100 subjects in each group.The participants were enrolled from the Cardiology IPD&OPD for the sample collection.The study employed ARM technique to extract the meaningful patterns and relationships from the clinical data with its original value.RESULTS The clinical dataset comprised 35 attributes from enrolled subjects.The analysis produced rules with a maximum branching factor of 4 and a rule length of 5,necessitating a 1%probability increase for enhancement.Prominent patterns emerged,highlighting strong links between health indicators and diabetes likelihood,particularly elevated HbA1C and random blood sugar levels.The ARM technique identified individuals with a random blood sugar level>175 and HbA1C>6.6 are likely in the“CAD-with-diabetes”group,offering valuable insights into health indicators and influencing factors on disease outcomes.CONCLUSION The application of this method holds promise for healthcare practitioners to offer valuable insights for enhancing patient treatment targeting specific subtypes of CAD with diabetes.Implying artificial intelligence techniques with medical data,we have shown the potential for personalized healthcare and the development of user-friendly applications aimed at improving cardiovascular health outcomes for this high-risk population to optimise the decision-making in patient care.

Coronary Artery Patterns in Diabetic Patients Undergoing Diagnostic Coronary Angiography-Data from a Major Cardiac Center in Yemen

Background: Diabetes mellitus (DM) is independently associated with an increased risk of cardiovascular mortality and morbidity, including coronary artery disease (CAD). CAD is a shared burden disease and the leading cause of death in developed and developing countries. We aimed to assess the angiographic patterns of coronary arteries in patients with DM in a developing country (Yemen) as the first study. Methods: This study is a cross-sectional, prospective, observational study that includes a total of 250 patients who were admitted for elective diagnostic coronary angiography. Results: 96 (38.4%) patients were diabetics;68% were male;mean age was 57 ± 11 years. The incidence of three-vessel disease was 31.2% of patients. Considering the severity of lumen occlusion, (11.2%) of patients had non-significant lesions, (37.6%) of patients had significant lesions, and (32%) had total occlusive lesions. Lesions were of LAD in 76%, RCA in 60%, and LCX in 52% of the population. Among diabetics, two and 3-vessel diseases (33.3% vs. 20.8% & 50% vs. 19.5%, P = 0.001), left main lesion (10.4% vs. 2.6%, P = 0.012), significant stenosis (41.7% vs. 35.1%, P = 0.032), total occlusion of coronary arteries (43.8% vs. 19.5%, P = 0.032) and type C lesion (66.7% vs. 35.1%, P = 0.010) were more frequent than non-DM patients. Conclusion: The burden of significant and severe coronary lesions is more common among DM, which may be the major cause of morbidity and mortality of DM in developing countries.

Effect of Dongchongxiacao(Cordyceps) therapy on contrast-induced nephropathy in patients with type 2 diabetes and renal insufficiency undergoing coronary angiography

OBJECTIVE: To study the protective effects of Dongchongxiacao(Cordyceps)(DCXC) on contrast-induced nephropathy(CIN) in patients with type 2 diabetes and renal insufficiency undergoing coronary angiography.METHODS: A total of 120 patients with type 2 diabetes whose estimated glomerular filtration rate(e GFR) was ≤ 60 m L/minee grou·1.73 m2,were divided randomly into thrps,basic treatment group(n = 41),standard DCXC therapy group(n = 39,2-g corbrin capsules,3 times/d,3 days before and after angiography),and intensive DCXC therapy group(n = 40,3-g corbrin capsules,3 times/d,3 days before and after angiography). Serum creatinine(Scr)and e GFR were assessed at the time of admission to hospital,and on days 1,2 and 3 after angiography. Urine neutrophil-gelatinase-associated-lipocalin(NGAL),kidney injury molecule-1(KIM-1) and interleukin-18(IL-18) were measured before angiography and at day 1 after angiography for all patients. The primary end point was the prevalence of CIN. The secondary end point was a 25% or greater reduction in e GFR.RESULTS: CIN occurred in 11 of 120 patients(9.17 %). The prevalence of CIN was lower in the DCXC treatment groups than in the basic treatment group(P < 0.05),with a more significant decrease in the prevalence of CIN in the intensive DCXC therapy group(P < 0.01). Compared with the basic treatment group,a lower proportion of patients in the DCXC treatment groups had an e GFR decrease of 25% or greater(P < 0.05); patients with an e GFR decrease of 25% or greater accounted for an even lower proportion in the intensive DCXC therapy group(P < 0.01). Within 1 day of the procedure,urine levels of KIM-1,NGAL and IL-18 in patients in the intensive DCXC therapy group were lower than those in the basic treatment group and standard therapy group(P < 0.05).CONCLUSION: DCXC treatment may protect against CIN in patients with type 2 diabetes and renal insufficiency undergoing coronary angiography,with intensive DCXC therapy being more effective.

Quantification of atherosclerotic plaque volume in coronary arteries by computed tomographic angiography in subjects with and without diabetes

Background:Diabetes mellitus(DM)is considered a cardiovascular risk factor.The aim of this study was to analyze the prevalence and volume of coronary artery plaque in patients with diabetes mellitus(DM)vs.those without DM.Methods:This study recruited consecutive patients who underwent coronary computed tomography(CT)angiography(CCTA)between October 2016 and November 2017.Personal information including conventional cardiovascular risk factors was collected.Plaque phenotypes were automatically calculated for volume of different component.The volume of different plaque was compared between DM patients and those without DM.Results:Among 6381 patients,931(14.59%)were diagnosed with DM.The prevalence of plaque in DM subjects was higher compared with nondiabetic group significantly(48.34%vs.33.01%,χ2=81.84,P<0.001).DM was a significant risk factor for the prevalence of plaque in a multivariate model(odds ratio[OR]=1.465,95%CI:1.258-1.706,P<0.001).The volume of total plaque and any plaque subtypes in the DM subjects was greater than those in nondiabetic patients significantly(P<0.001).Conclusion:The coronary artery atherosclerotic plaques were significantly higher in diabetic patients than those in non-diabetic patients.

Medical therapy vs early revascularization in diabetics with chronic total occlusions:A meta-analysis and systematic review

BACKGROUND Management of chronic total occlusions(CTO)in diabetics is challenging,with a recent trend towards early revascularization[ER:Percutaneous coronary intervention(PCI)and bypass grafting]instead of optimal medical therapy(OMT).We hypothesize that ER improves morbidity and mortality outcomes in diabetic patients with CTOs as compared to OMT.AIM To determine the long term clinical outcomes and to compare morbidity and mortality between OMT and ER in diabetic patients with CTOs.METHODS Potentially relevant published clinical trials were identified in Medline,Embase,chemical abstracts and Biosis(from start of the databases till date)and pooled hazard ratios(HR)computed using a random effects model,with significant P value<0.05.Primary outcome of interest was all-cause death.Secondary outcomes included cardiac death,prompt revascularization(ER)or repeat myocardial infarction(MI).Due to scarcity of data,both Randomized control trials and observational studies were included.4 eligible articles,containing 2248 patients were identified(1252 in OMT and 1196 in ER).Mean follow-up was 45-60 mo.RESULTS OMT was associated with a higher all-cause mortality[HR:1.70,95%confidence interval(CI):0.80-3.26,P=0.11]and cardiac mortality(HR:1.68,95%CI:0.96-2.96,P=0.07).Results were close to significance.The risk of repeat MI was almost the same in both groups(HR:0.97,95%CI:0.61-1.54,P=0.90).Similarly,patients assigned to OMT had a higher risk of repeat revascularization(HR:1.62,95%CI:1.36-1.94,P<0.00001).Sub-group analysis of OMT vs PCI demonstrated higher all-cause(HR:1.98,95%CI:1.36-2.87,P=0.0003)and cardiac mortality(HR:1.87,95%CI:0.96-3.62,P=0.06)in the OMT group.The risk of repeat MI was low in the OMT group vs PCI(HR:0.53,95%CI:0.31-0.91,P=0.02).Data on repeat revascularization revealed no difference between the two(HR:1.00,95%CI:0.52-1.93,P=1.00).CONCLUSION In diabetic patients with CTO,there was a trend for improved outcomes with ER regarding all-cause and cardiac death as compared to OMT.These findings were reinforced with statistical significance on subgroup analysis of OMT vs PCI.

不同葡萄糖代谢状态人群AIP、Ty G与冠状动脉疾病及其严重程度的关系研究

目的探讨不同葡萄糖代谢状态人群动脉粥样硬化指数(AIP)、甘油三酯-葡萄糖指数(TyG)与冠状动脉疾病(CAD)及其严重程度的关系。方法回顾性选取2021年1月至2024年3月在丽水市人民医院行冠状动脉CT血管造影检查的340例患者为研究对象,其中葡萄糖代谢状态正常153例,糖尿病前期110例,糖尿病77例。按照检查结果分为非CAD组92例、CAD单支血管狭窄组90例和CAD多支血管狭窄组158例。比较3组患者临床资料,采用多因素logistic回归和ROC曲线分析AIP、TyG与不同葡萄糖代谢状态下发生CAD及其严重程度的关系。结果3组患者吸烟比例、AIP、TyG、葡萄糖代谢状态、甘油三酯以及低密度脂蛋白胆固醇比较,差异均有统计学意义(均P<0.01)。无论葡萄糖代谢状态如何,AIP、TyG均是发生CAD的独立危险因素(均P<0.01);AIP、TyG预测葡萄糖代谢状态正常患者发生CAD的AUC、最佳截断值分别为0.703、0.174和0.738、3.120,预测糖尿病前期患者发生CAD的AUC、最佳截断值分别为0.725、0.159和0.706、2.803,预测糖尿病患者发生CAD的AUC、最佳截断值分别为0.711、0.150和0.709、2.776。AIP是葡萄糖代谢状态正常患者发生CAD严重程度的独立危险因素(P<0.001);预测葡萄糖代谢状态正常患者发生CAD严重程度的AUC、最佳截断值为0.713、0.293。结论AIP、TyG有助于诊断不同葡萄糖代谢状态下发生CAD及其严重程度,及早识别CAD高危人群。

能谱CT冠状动脉血管成像对糖尿病患者合并冠状动脉病变的诊断价值研究

目的能谱CT冠状动脉血管成像(CCTA)对糖尿病患者合并冠状动脉病变的预测价值。方法选取2020年8月至2022年8月福建医科大学附属福州市第一医院收治的88例疑似2型糖尿病(T2DM)合并冠状动脉病变患者,共随机选取352个冠脉节段,均接受能谱CCTA检查,以冠状动脉造影(CAG)为金标准,分析能谱CCTA对T2DM患者冠状动脉病变、冠脉狭窄程度及冠脉斑块类型的诊断效能。结果88例T2DM患者能谱CCTA诊断有56例合并冠状动脉病变,352个冠脉节段中,无狭窄134例,轻度狭窄115例,中度狭窄68例,重度狭窄10例,无斑块135例,钙化斑块26例,非钙化斑块103例,混合斑块67例。能谱CCTA诊断T2DM患者冠状动脉病变的准确度为88.64%,Kappa值为0.733;诊断冠脉轻度狭窄、中度狭窄、重度狭窄的准确度分别为95.74%、95.82%、97.73%,Kappa值分为0.900、0.857、0.702;诊断冠脉钙化斑块、非钙化斑块、混合斑块的准确度分别为96.01%、97.43%、98.24%,Kappa值分为0.754、0.964、0.969。结论能谱CCTA诊断T2DM患者冠状动脉病变、冠脉狭窄程度及冠脉斑块类型均具有较好的诊断效能,能为临床T2DM合并冠状动脉病变早期诊断、治疗工作提供一定参考,值得推广。

冠状动脉狭窄程度与冠心病危险因素的相关性分析

目的探讨冠状动脉狭窄程度与冠心病危险因素的相关性。方法连续性收集我科行冠状动脉造影的患者121例,根据造影结果,将患者分为冠心病组89例与对照组32例。收集2组患者临床、实验室和影像学资料,采用单因素和多因素logistic回归模型进行分析。结果冠心病组男性、糖尿病、吸烟比例和LDL-C水平均高于对照组,HDL-C水平低于对照组(P<0.05);多因素logistic回归分析示,糖尿病(OR=3.769,P=0.042)、LDL-C水平(OR=1.873,P=0.021)是冠心病的独立危险因素。中、重度冠状动脉狭窄患者吸烟比例均高于轻度狭窄者,中度狭窄患者男性比例、年龄与尿酸水平和重度狭窄患者高血压、糖尿病比例均高于轻度狭窄者,差异均有统计学意义(P<0.05);logistic回归分析示,年龄(OR=1.094,P=0.001)、高血压(OR=3.340,P=0.003)、糖尿病(OR=3.877,P=0.003)和吸烟(OR=4.536,P=0.003)与冠状动脉狭窄程度相关。结论冠心病的危险因素与冠状动脉狭窄程度存在显著相关性,其中糖尿病是两者共同的重要危险因素。

老年冠心病合并糖尿病的冠状动脉病变特点

目的探讨老年冠心病(CAD)合并2型糖尿病(DM)患者冠状动脉病变特点。方法对198例老年CAD合并DM患者(DM组)和387例老年CAD非合并DM患者(NDM组)的临床资料及冠脉造影结果进行统计分析,分别记录各组的冠脉病变特点。结果 2组间年龄、体质量指数(BMI)、吸烟史、高血压史、低密度脂蛋白胆固醇(LDL-C)、血肌酐(Cr)及CAD家族史差异均无统计学意义(P>0.05);DM组糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、三酰甘油(TG)及C反应蛋白(CRP)明显高于NDM组(P<0.05);2组间的左主干(LM)病变、单支病变、双支病变情况差异无统计学意义(P>0.05);但是DM组三支病变的发生率与NDM组比较差异显著(P<0.05),平均置入支架数比较差异极显著(P<0.01);FINS、CRP及HbA1c是多支冠状动脉病变的独立危险因子。结论 2型DM合并CAD患者病变累及冠状动脉数目较多,血管病变弥漫。

心肌灌注显像与双源CT冠状动脉成像对糖尿病并发冠心病患者冠状动脉狭窄诊断价值的比较

目的:评估并比较心肌灌注显像(MPI)与双源CT冠状动脉成像(DS-CTCA)检查对糖尿病并发冠心病(CHD)患者冠状动脉狭窄的诊断价值,阐明2种检查方法联合对糖尿病并发CHD患者的临床应用价值。方法:选取52例诊断为糖尿病并发CHD患者,分别接受MPI与DS-CTCA检查,比较2种检查方法诊断左主干(LM)、左前降支(LAD)、左回旋支(LCX)和右冠状动脉(RCA)等冠状动脉主干分支狭窄程度的差异。以冠状动脉血管造影(CAG)为金标准,比较2种检查方法单独诊断的灵敏度、敏感度和准确度的差异,比较2种检查方法联合平行诊断与系列诊断的灵敏度、敏感度和准确度的差异。结果:MPI检查与DS-CTCA检查对LM和LAD的狭窄程度诊断差异无统计学意义(P>0.05),对LCX和RCA的狭窄程度诊断差异有统计学意义(P<0.05)。与MPI检查比较,DS-CTCA检查对糖尿病并发CHD患者冠状动脉分支血管狭窄诊断的灵敏度较低,为71.0%vs 90.1%,差异有统计学意义(P=0.035);特异度较高,为85.7%vs 58.4%,差异有统计学意义(P=0.027);但2种检查方法的准确度为76.4%vs 78.4%,差异无统计学意义(P=0.062)。与平行诊断比较,系列诊断的特异度及准确度较高,分别为93.5%vs 33.8%和94.7%vs 71.2%,差异均有统计学意义(P=0.001,P=0.030);灵敏度为95.4%vs 93.1%,差异无统计学意义(P=0.074)。结论:DS-CTCA检查与MPI检查在诊断糖尿病并发CHD患者冠状动脉狭窄的准确度上无差异,但是2种检查方法的系列诊断能更加有效地提高诊断糖尿病并发CHD患者冠状动脉狭窄的准确度。

冠心病患者糖化血红蛋白水平与冠状动脉病变程度的相关性研究

目的研究不同糖代谢情况的冠心病患者糖化血红蛋白(HbA1c)水平与冠状动脉病变程度的关系。方法回顾性分析某三级甲等医院心内科2009年2月—2011年10月行冠状动脉造影(CAG)明确诊断为冠心病的患者2 336例。根据糖代谢情况分为3组,即冠心病伴糖耐量正常组(正常组)970例、冠心病伴糖耐量异常组(异常组)781例和冠心病伴糖尿病组(糖尿病组)585例。对3组患者的一般资料进行比较,分析HbA1c水平、冠状动脉狭窄程度及冠状动脉病变支数之间的相关性和冠状动脉病变的危险因素。结果 3组患者在冠状动脉狭窄程度、冠状动脉病变支数、年龄、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、HbA1c、三酰甘油(TG)方面比较,差异有统计学意义(P<0.05)。经Spearman秩相关分析显示,HbA1c水平与冠状动脉狭窄程度,冠状动脉狭窄程度与冠状动脉病变支数之间均呈正相关(rs=0.705,0.120;P<0.01)。采用Logistic回归分析冠状动脉病变的危险因素,结果显示,年龄、性别、高血压、HbA1c、FPG、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)进入回归方程。结论 HbA1c水平与冠状动脉狭窄程度以及冠状动脉病变支数之间存在显著的相关性,是影响冠状动脉病变严重程度的重要因素。

2型糖尿病合并冠心病患者的脂代谢和冠状动脉造影分析

116例2型糖尿病合并冠心病患者的甘油三酯和低密度脂蛋白胆固醇水平明显高于无糖尿病的冠心病患者,高密度脂蛋白胆固醇明显低于无糖尿病的冠心病患者。其中血脂异常者和血脂正常者相比,血管病变的数目更多,程度更重,范围更弥漫。

单中心老年心血管病危险因素控制现状分析

目的了解老年患者心血管病危险因素控制现状。方法选择我院老年内科住院治疗的疑诊冠心病的老年患者256例,测定血糖、血脂水平,进行24h动态血压监测,根据相关指南推荐的血压、血糖及血脂达标值判断达标情况。根据冠状动脉造影结果将入选者分为冠心病组208例与非冠心病组48例,比较2组上述危险因素控制情况。结果 256例患者中,209例(81.6%)合并高血压,24h、昼间及夜间平均血压达标率分别为75.1%、82.8%和59.3%;99例(38.7%)合并糖尿病,血糖达标率70.7%;154例(60.2%)合并血脂异常,LDL-C达标率41.4%。冠心病组与非冠心病组血压、血糖达标率比较,差异无统计学意义(P>0.05),冠心病组LDL-C达标率低于非冠心病组,差异有统计学意义(38.5%vs 54.2%,P<0.05)。结论老年心血管病高危患者中,血压、血糖达标率高,LDL-C达标率较低,尤其心血管病极高危的冠心病患者LDL-C达标率更低,应重视老年患者心血管病风险评估,并进一步加强对血脂的干预力度。

心肌缺血总负荷对可疑冠心病患者的诊断价值

目的分析心肌缺血总负荷(TIB)单独或联合冠心病危险因素对可疑冠心病患者的诊断价值。方法选择可疑冠心痛患者89例,同期行同步动态心电图监测及冠状动脉造影(CAG)后将患者分为:CAG阳性组52例,CAG阴性组37例。对2组TIB及危险因素进行logistic回归分析,计算TIB和(或)有意义指标检出冠心病的敏感性、特异性、阳性预测值和阴性预测值。结果 TIB检测冠心病的敏感性32.7%,特异性84.5%,阳性预测值77.3%,阴性预测值47.8%;男性与TIB阳性比较,诊断冠心病的敏感性升高(P<0.01);TIB阳性+糖尿病与TIB阳性比较,敏感性降低、特异性及阳性预测值升高(P<0.05,P<0.01)。年龄、男性和糖尿病是冠心病的独立危险因素。结论中老年男性及糖尿病患者发生冠心病的危险性明显升高;TIB与相关危险因素联合可以提高冠心病的诊断价值。在对可疑冠心病患者进行鉴别诊断时,TIB阳性、中老年男性及糖尿病具有重要参考价值。

糖尿病与冠脉粥样硬化病变关系的临床研究

目的 :用冠脉造影定量分析方法探讨糖尿病与冠状动脉粥样硬化的关系。方法 :统计分析251例经冠脉造影的急性心肌梗死患者的造影资料 ,计算冠脉造影积分 ,并按有无糖尿病分为2组。结果 :非糖尿病组205例 ,平均(59.60±12.55)岁 ;糖尿病组46例 ,平均(62.02±8.22)岁。糖尿病组较非糖尿病组有较高的冠脉积分(coronaryscore)、范围积分(extentscore) ,差别有统计学意义(P<0.05)。狭窄级别的总积分 (totalscore)和粥样硬化积分(atheroscleroticscore)2组差异无统计学意义。糖尿病组3支血管病变发生率与非糖尿病组接近。结论 :冠心病急性心肌梗死伴糖尿病患者较非糖尿病患者血管狭窄的程度重、广泛且弥漫。

合并2型糖尿病老年冠心病患者冠状动脉病变程度的研究

目的:探讨合并2型糖尿病老年冠心病患者的临床特点和冠状动脉病变特征。方法:回顾性分析本院1 102例老年冠心病患者的临床资料及冠状动脉造影结果。结果:与不合并糖尿病患者比较,合并2型糖尿病肥胖和高血压比例、最高收缩压、最高舒张压、三酰甘油、血糖、尿酸均显著增高,高密度脂蛋白胆固醇酯水平显著降低,平均冠状动脉病变处数、长病变、分叉病变和多支病变发生率显著增高(P<0.05),冠状动脉病变更严重、更弥漫,平均置入支架数目多(P<0.01),平均支架直径小而长(P<0.05)。结论:合并糖尿病的老年冠心病患者代谢异常更显著,冠状动脉硬化范围更广、程度更重,多支病变、弥漫病变常见,需要介入干预的比例高。

老年冠心病合并2型糖尿病患者冠状动脉粥样硬化斑块钙化特征

目的探讨老年冠心病合并2型糖尿病患者冠状动脉粥样硬化斑块钙化的总负荷和钙化特征。方法选择稳定性心绞痛患者72例,其中合并2型糖尿病40例(糖尿病组),无糖尿病32例(非糖尿病组)。均行冠状动脉造影,选取一处狭窄50%～70%的斑块进行血管内超声检查。测量斑块钙化弧面积,如果同一斑块内有多个钙化,分别测量每个钙化的弧面积,并将每个弧面积相加得到钙化总负荷,并记录每个斑块内钙化数量。结果与非糖尿病组比较,糖尿病组患者斑块钙化弧面积明显增大,钙化数量明显增多[(1343.0±1007.3)度×mm vs(707.7±589.0)度×mm,(2.4±2.0)个vs(1.4±1.3)个,P<0.05];糖尿病组与非糖尿病组每个钙化弧面积比较差异无统计学意义(P>0.05)。结论老年冠心病合并糖尿病患者冠状动脉钙化负荷更重,这种负荷的加重是由于斑块内钙化数量的增加所致,合并和不合并糖尿病的老年冠心病患者冠状动脉粥样硬化斑块钙化数量相同。

颈动脉超声检查对糖尿病合并冠心病患者的应用价值研究

目的探讨颈动脉超声检查对糖尿病合并冠心病患者的应用价值。方法选择2016年10月—2017年10月我院收治的初诊冠心病患者181例,根据是否合并2型糖尿病分为观察组79例,对照组102例。对2组的血压、血脂、糖化血红蛋白、冠脉造影结果及颈动脉超声结果进行分析,观察Gensini积分与Crouse、CA积分和斑块个数的相关性。结果 2组血压、胆固醇、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇比较差异无统计学意义(P>0.05),观察组甘油三酯、糖化血红蛋白水平高于对照组(P<0.05)。观察组Gensini积分、3支病变、弥漫性病变发生率均高于对照组(P<0.05)。观察组CA积分、Crouse积分、斑块个数均高于对照组,(P<0.05)。Gensini积分与Crouse、CA积分和斑块个数呈正相关(r=0.25、0.36、0.27,P<0.01)。结论对于冠心病的高危人群,尤其是2型糖尿病患者,可通过颈动脉超声进行筛查,以达到早期诊断,早期控制疾病进展及提高治疗效率的目的。

糖尿病合并冠心病患者的冠脉造影分析

目的旨在观察2型糖尿病合并冠心病患者的冠脉病变情况。方法应用JUDKINS方法对66例2型糖尿病合并冠心病患者进行冠脉造影检查，并与66例年龄、性别配对的非糖尿病冠心病患者比较。结果2型糖尿病患者的冠脉病变多数是三支血管病变（占57．58％），其病变弥漫，且数目多；并且糖尿病的病程超长，越易发生多支血管病变，造成治疗上的困难。结论2型糖尿病的及早预防、合理有效的治疗对冠心病的防治甚为重要。