糖代谢异常患者冠状动脉病变分析

目的:探讨冠心病合并糖调节受损患者的冠状动脉病变特点。方法:回顾分析2000年5月~2007年11月冠状动脉造影阳性患者720例,分为糖尿病组(208例)、糖耐量减低组(96例)、空腹血糖受损组(30例)和非糖代谢异常组(386例)。所有患者均测定空腹血糖、空腹胰岛素、餐后2 h血糖、血胆固醇、三酸甘油、低密度脂蛋白、高密度脂蛋白、C反应蛋白及糖化血红蛋白,观察其年龄、冠心病危险因素(包括高血压、高胆固醇血症及体质量指数BMI及吸烟)和冠状动脉病变情况。结果:1.4组在年龄、性别、危险因素等方面差异无统计学意义(P>0.05)。2.冠心病合并糖尿病组、糖耐量减低组、空腹血糖受损组双支病变率分别为38%、27%、和30%,与非糖代谢异常组18%比较差异有统计学意义(P<0.01);3支病变率分别为43%、40%、和37%,与非糖代谢异常组20%比较差异有统计学意义(P<0.01);糖耐量减低组、空腹血糖受损组与糖尿病组相比,3支病变率、病变程度差异无统计学意义(P>0.05)。3.Logistic回归分析表明空腹胰岛素、C反应蛋白、糖化血红蛋白及低密度脂蛋白是多支冠状动脉病变的独立危险因子。结论:糖调节受损与2型糖尿病有类似血管损害,糖耐量试验对及时发现血糖异常非常重要。

Clinical analysis of the coronary anglographic characteristics in patients with coronary disease and impaired glucose regulation (IGR)

Objective： To study of clinic and the coronary angiographic Characteristics in patients with coronary disease and impaired glucose regulation（ IGR）. Method：To analyse the cononary angiographic characteristics of 334 IGR patiens （including 208 T2DM, 96 IGT and 30 1FG） with CAD and compared with 386 nondiabetic patients with CAD, of patients who underwent coronary angiography during the interal between 2000 and 2007. Fast blood glucose （ FBG ）, Fasting insulin （ FINS ）, postprandial 2 hours blood glucose （ P2hBG ）, cholesterol （ CHO ）, triglyceride （TG）, low density lipoprotein cholesterol （LDL）, high density lipoprotein cholesterol （HDL）, C-Reactive Protein （CRP） were measured. Age, risk factors of coronary heart disease （including hypertension, hypercholesteremia and smoking） and coronary artery lesions were observed at the same time. Result： 1. No significant differences in age, sex and risk factors were observed among the four groups（ P 〉 0.05）. 2. The incidences of double vessel lesions in the IGR group were significantly higher than those in the nondiabetic group （38%, 27%, 30% vs 18% respecti-vely）（ P 〈 0.01 ）; The incidences of triple vessel lesions in the IGR group were significantly higher than those in the nondiabetic group （43 %, 40 %, 37 % vs 20 % respectively）（ P 〈 0.01 ）; No significant difference between three grounps of DM, IGT and IFG in the degree of lesion（ P 〉 0.05 ）. 3. FINS, CRP, HbA and LDL were significantly independent risk factor of double or triple vessel lesions. Conclusion： IGR is similar with T2DM in vessel lesions;OGTT test is very important to find patients with abnormal glucose metabolism.