2型糖尿病合并冠心病患者冠状动脉狭窄相关因素分析

目的探讨2型糖尿病（T2DM）合并冠心病患者冠状动脉狭窄程度的相关因素。方法选择52例由冠状动脉造影术确诊为冠心病且合并T2DM住院患者（A组），Gensini评分系统对冠状动脉造影结果进行评分；选择同期住院的48例不合并冠心病的T2DM患者为对照组（B组）。分别检测两组空腹血糖（FPG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、γ-谷氨酰转肽酶（GGT），比较两组间上述指标的水平，分析冠状动脉狭窄程度（Gensini评分）与各指标间的相关性。结果①A组BMI、FPG、HbA1c、TC、TG、LDL与B组比较，差异均有统计学意义（P〈0．05，P〈0．01）；②Pearson相关分析显示，BMI、FPG、HbA1c、TC、LDL、GGT与Gensini评分呈显著正相关（r=0．802、r=0．660、r=0．614、r=0．508、r=0．347、r=0．808，P〈0．05），HDL与Gensini评分旱显著负相关（r=-0．371，P〈0．05）；③多元线性回归分析显示，GGT、LDL—C、BMI、FPG是Gensini评分的影响因素（P〈0．05）。结论降低体重、控制血糖、调节血脂是T2DM心血管病变防治措施的重要组成部分。GGT水平升高与心血管疾病及T2DM密切相关，可作为T2DM合并心血管病变的预测指标。

Correlation Factors of Coronary Artery Stenosis in Patients with Type 2 Diabetes Mellitus Complicated with Cor- onary Heart Disease

Objective To explore correlation factors of coronary artery stenosis in patients with type 2 diabetes mellitus （T2DM） complicated with coronary heart disease （CHD）. Methods Results of coronary angiography of 52 in- patients, who were confirmed as having T2DM complicated with CHD （group A） by coronary angiography, were evalua- ted with Gensini scoring system, and 48 patients with T2DM were selected as the control group （group B）. The levels of fasting plasma glucose （FPG） , glycosylated hemoglobin （HbAlc） , total cholesterol （ TC ） , triglyceride （TG） , high density lipoprotein （HDL） , low density lipoprotein （LDL） and γ-glutamyl transpeptidase （GGT） of patients in the two groups were detected and compared, and the correlation between coronary artery stenosis （Gensini score） and the each index were respectively analyzed. Results ①The differences in levels of BMI, FPG, HbAlc, TC, TG and LDL be- tween group A and B were statistically significant （P 〈 0.05, P 〈 0.01 ）. ② Pearson correlation analysis showed that the levels of BMI, FPG, HbAlc, TC, LDL and GGT had significantly positive correlation with Gensini score （r =0. 802, r = 0. 660, r = 0. 614, r = 0. 308, r = 0. 347, r = 0. 808, P 〈 0.05 ） , while the HDL level had significantly negative corre- lation with Gensini score （r = -0. 371, P 〈 0.05 ）. ③The multiple linear regression analysis showed that the levels of GGT, LDL-C, BMI and FPG affected the Gensini score （P 〈 0.05）. Conclusion The important measures for preven- tion and treatment of patients with T2DM complicated with CHD are losing weight, controlling blood glucose and regula- ting blood lipids. The elevated GGT level is closely related with the cardiovascular disease and diabetes mellitus, and it may be considered as a predictive index for diabetic cardiovascular disease complicated with cardiovascular diseases.