老年急性冠脉综合征合并糖尿病患者的冠脉病变及其危险因素

目的：研究老年急性冠脉综合征（ACS）合并糖尿病患者的冠状动脉病变特点及相关危险因素。方法：选择老年ACS患者209例，被分为两组：ACS合并糖尿病组（观察组，73例），ACS无糖尿病组（ACS对照组，136例）。并根据冠状动脉造影结果，对其冠脉病变特点进行分析。结果：观察组三支病变（50．68％）、弥漫性病变（27．22％）以及Gensini积分（24．21±4．37）分，均显著高于对照组[30．15％，16．09％，（18．53±3．59）分，P〈0．05～〈0．01]。多元Logistic逐步回归分析显示观察组高血压的合并风险比值（OR）为1．455，P=0．013，甘油三酯OR为1.930，P=0．003，总胆固醇OR为1．552，P=0．006，均为其危险因素。结论：老年急性冠脉综合征合并糖尿病患者的冠脉病变复杂、严重，甘油三酯、总胆固醇以及合并高血压病史是其发生、发展的重要危险因素。

Characteristics of coronary artery lesions in aged patients with acute coronary syndrome and diabetes mellitus and its risk factors

Objective： To study the characteristics of coronary artery lesions in aged patients with acute coronary syndrome （ACS） and diabetes mellitus and its risk factors. Methods： A total of 209 aged ACS patients were divided into two groups according to combined with DM （73 patients） or not （136 patients）. The results of coronary angiography were analyzed compared between two groups. Results： Compared with the control group, the ACS＋DM patients suffered more three-vessel lesions （30.15% vs. 50.68%, P〈0.01）, diffuse lesions （16.09% vs. 27.22%, P〈 0.05）, and the Gensini score were also markedly increased [ （18.53±3.59） scores vs. （24. 21±4.37） scores, P〈 0.05]. Logistic stepwise regression analysis revealed that the hypertension, TG and TC were risk factors （OR： 1. 455±1. 930, P〈0.05 all）. Conclusion： Coronary artery lesion is more severity in aged patients with acute coronary syndrome and diabetes mellitus; the hypertention, TG and TC are the important risk factors for it.