首次冠状动脉造影患者糖代谢分布及血管造影特点分析

目的调查首次冠状动脉造影人群的糖代谢分布,分析血管造影特点。方法对553例疑似冠心病患者测量形体参数,检验血液生化指标,进行冠状动脉造影。用1999 WHO糖尿病诊断标准评价糖代谢分布,美国心脏病协会规定的冠状动脉狭窄程度评判标准和Gensin i评分系统对造影结果进行定量评价,根据造影结果及糖代谢状态对患者进行分组比较。结果研究对象平均年龄60岁(60.1±9.7),277例(50.1%)糖耐量正常,276例(49.9%)糖代谢异常,其中糖调节受损127例(23.0%),新诊断糖尿病61例(11.0%),已知糖尿病88例(15.9%)。冠心病组中糖代谢异常者多于非冠心病组(56.4%和34.5%,P<0.05)。糖尿病组多支病变发生率和Gensin i积分均高于非糖尿病组,分别为63.8%和44.1%,15分和20分(P均<0.05)。结论冠状动脉造影人群糖代谢异常多见,糖尿病患者多支病变发生率和冠状动脉狭窄程度高于非糖尿病患者。

Glucose metabolism status and angiographic features of coronary artery in patients undergoing their first coronary angiography: study of 553 cases

OBJECTIVE: To investigate the correlation between glucose metabolism status and coronary artery lesion in the patients undergoing their first coronary angiography (CAG). METHODS: Oral glucose tolerance test (OGTT) and CAG were performed in 553 patients with suspected or confirmed coronary artery disease (CAD), aged 60.1 +/- 9.7. The anthroposomatologic parameters, blood pressure, HbA1c, and lipid profile of these patients were collected. Their glucose metabolism status was assessed based on the WHO diagnostic criteria of diabetes mellitus 1999 and American Heart Association's grading standards for evaluating coronary artery stenosis and Gensini score were applied to analyze the coronary artery lesion. According to the CAG results the patients were divided into CAD group and non-CAD group and then the glucose metabolic characteristics in both groups were analyzed by comparison based on the glycometabolic status. The patients were also grouped into diabetic and non-diabetic groups and the coronary artery angiographic features in both groups were compared. RESULTS: Among the 533 patients 277 (50.1%) had normal OGTT, 127 (23.0%) were diagnosed as with impaired glucose regulation, 61 (11%) were newly diagnosed as with type 2 diabetes mellitus, and the other 88 patients (15.9%) were already known diabetics. The prevalence of abnormal glycometabolism in the CAD group was 56.4%, significantly higher than that in the non-CAD group (34.5%, P < 0.05). The prevalence of multiple branches involvement in the diabetic group was 63.8%, significantly higher than that of the non-diabetic group (44.1%, P < 0.05), and the Gensini score in the diabetic group was 15 (30.5), significantly higher than that of the 20 (27), P < 0.05]. CONCLUSION: Abnormal glycometabolism is common in the population undergoing coronary angiography. Both the prevalence of multiple branches involvement and the degree of stenosis of coronary in the diabetics are higher than that in those without diabetes.