2型糖尿病与冠状动脉病变程度的相关性分析

目的探讨冠状动脉病变程度与2型糖尿病(type 2 diabetes mellitus,T2DM)的相关性。方法收集9289例行诊断性冠状动脉造影疑诊冠状动脉疾病(coronary artery disease,CAD)的患者进行回顾性分析,以冠状动脉造影阳性(主要血管直径狭窄≥50%)作为诊断CAD的标准,确诊CAD者6119例(65.9%),未确诊CAD患者3170例(34.1%),其中合并T2DM的2150例(23.1%)患者作为观察组,未合并T2DM的7139例(76.9%)患者作为对照组。采用Gensini积分评价冠状动脉造影病变程度,并计数冠状动脉病变的支数。采用单因素方差分析及多因素回归分析评价糖尿病与冠状动脉狭窄程度间的关系。结果 2150例合并T2DM患者中确诊CAD患者1717例,占79.9%;7139例未合并T2DM患者中确诊CAD的患者4402例,占61.7%。糖尿病患者CAD患病率显著高于非糖尿病组(79.9%比61.7%,χ2=4.027,P<0.001),且冠状动脉病变程度更为严重,表现为患者平均病变支数更多(1.63±1.11比1.11±1.10,t=19.20,P<0.001)、Gensini积分更高(35.47±36.80比22.65±31.42,t=15.92,P<0.001);多因素Logistic回归分析显示糖尿病是CAD发生的的最强独立危险因素(OR值2.127,95%CI1.869～2.419,P<0.001)。结论糖尿病患者的CAD发病率明显高于非糖尿病组;糖尿病组患者冠状动脉狭窄程度更为严重;糖尿病与CAD发生的具有明显正相关性。

Correlation between type 2 diabetes mellitus and severity of coronary artery stenosis

Objective To discuss the relationship between type 2 diabetes mellitus (T2DM)and the severity of coronary artery stenosis in patients with Coronary artery disease (CAD) Methods A total of 9289 consecutive patients underwent coronary angiography were selected A positive coronary angiography for diagnosis of CAD was taken as stenosis of major vessels≥50% 6119 consecutive patients with angiographically diagnosed as CAD and 3170 belonged to non CAD were included in the study The patients were divided into two subgroups: patients with type 2 diabetes (n=2150) and patients without type 2 diabetes (n=7139) Severity of CAD was assessed by the Gensini score and the number of arteries (0-3) with >50% stenosis in the angiography We observed the relationship between type 2 diabetes and coronary stenosis by both single factor analysis and multivariate binary Logistic regression analysis Results In 2150 patients with type 2 diabetes,1717 cases (79.9%) were diagnosed as CAD but in 7139 patients without type 2 diabetes,4402 cases (61.7%) were diagnosed as CAD The prevalence of CAD was higher in the diabetic group than in the non diabetic group (79.9% vs 61.7%,χ2=4.027, P<0.01) Furthermore, the average number of stenotic coronary arteries was higher (1.63±1.11 vs 1.11±1.10,t=19.20, P<0.001), as well as Gensini score was higher (35.47±36.80 vs 22.65±31.42,t=15.92, P<0.001) Logistic regression analysis showed that T2DM was the most significant independent risk factor of CAD (OR=2.127,95%CI-1.869-2.419,P<0.001) Conclusions The incidence of CAD was higher in the diabetic group, furthermore, who had more severe coronary artery stenosis Diabetes was a prominent risk factor of CAD