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目的探讨糖代谢异常对冠脉病变程度的影响。方法选择医院就诊的239例冠心病患者,依血糖水平分为糖尿病(DM)组、血糖调节受损(IGR)组、正常血糖组。冠状动脉造影检查冠脉病变程度,并与其血糖水平进行综合分析。结果左冠状动脉前降支(LAD)与左回旋支(LCX)病变在3组患者中差异存在统计学意义(P<0.01),IGR组和DM组较血糖正常组发生LAD与LCX病变显著增加(P<0.05)。而右冠状动脉(RCA)与左冠状动脉主干(LM)病变分布差异无统计学意义(P>0.05)。仅单支病变者在血糖正常组中占比高(47.37%),与另两组差异存在统计学意义(P<0.01),冠脉三支病变者在DM组中占比最高(51.47%),显著高于另两组(P<0.05)。空腹血糖、餐后2小时血糖、糖化血红蛋白均随冠脉病变程度增加而增加,且差异存在统计学意义(P<0.05)。结论糖尿病合并冠心病冠脉受累范围广。高血糖冠心病患者冠脉损伤程度重,常合并多支病变。随着血糖增加,冠脉病变程度加重,三支病变比例在IGR患者和DM患者中明显增加。对血糖受损的冠心病患者进行早期心血管风险评估,积极干预,对诊断治疗冠心病、改善预后具有重要的临床意义。
Objective To investigate the effect of abnormal glucose metabolism on the severity of coronary artery disease. Methods A total of 239 patients with coronary heart disease were selected and divided into diabetes mellitus (DM) group, impaired glucose regulation (IGR) group and normal blood glucose group according to their blood glucose levels. Coronary angiography coronary lesions, and its blood glucose levels were analyzed. Results The differences of LAD and LCX between the three groups were statistically significant (P <0.01). The incidence of LAD and LCX in IGR group and DM group were significantly higher than those in normal glucose group (P <0.05). There was no significant difference in the distribution of lesions between right coronary artery (RCA) and left main coronary artery (LM) (P> 0.05). Only single vessel disease accounted for the highest proportion in the normal blood glucose group (47.37%), and the difference between the other two groups was statistically significant (P <0.01). The three coronary lesions in the DM group accounted for the highest proportion (51.47% , Significantly higher than the other two groups (P <0.05). Fasting blood glucose, 2-hour postprandial blood glucose and HbA1c levels increased with the degree of coronary artery lesion, and the difference was statistically significant (P <0.05). Conclusion Coronary heart disease in diabetic patients with a wide range of coronary involvement. Patients with hyperglycemia and coronary heart disease severity of coronary artery injury, often complicated by multi-vessel disease. With the increase of blood glucose, the degree of coronary artery disease increased, the proportion of three lesions was significantly increased in IGR patients and DM patients. The early cardiovascular risk assessment of coronary heart disease patients with impaired glucose tolerance, active intervention, diagnosis and treatment of coronary heart disease, improve prognosis has important clinical significance.