冠心病合并2型糖尿病患者临床表现及冠状动脉病变特点分析

目的探讨冠心病合并2型糖尿病患者的临床表现及冠状动脉病变特点。方法将入选的480例冠心病患者分为糖尿病组(DM组)和非糖尿病组(NDM组),统计分析2组患者的危险因素、临床表现、并发症及冠状动脉病变特点。结果(1)危险因素比较:2组患者性别、高血压病史、TC、LDL-C、阳性家族史等比较差异无统计学意义(P>0.05),DM组肥胖患者比例及TG水平均高于NDM组,吸烟患者少于NDM组(P<0.05)。(2)临床表现比较:2组患者典型胸痛症状比例差异无统计学意义(P>0.05),DM组患者心肌梗死、心律失常、心力衰竭及心源性休克等并发症均多于NDM组(P<0.05)。(3)冠状动脉造影结果:2组患者LAD、LCX、RCA分布方面比较差异无统计学意义(P>0.05),DM组患者LM、三支及弥漫性血管病变方面多于NDM组(P<0.05)。(4)2组冠状动脉狭窄程度积分比较,1分、2分比例差异无统计学意义(P>0.05),3分、4分、5分比例差异显著(P<0.05)。结论冠心病合并糖尿病患者心肌梗死发病率高,临床并发症多,冠状动脉病变弥漫且狭窄程度严重,累及左主干较多。临床积极早期干预血糖有利于冠心病的防治。

Clinical manifestations and coronary lesion characteristics of coronary heart disease patients complicated by type 2 diabetes

Objective To investigate the clinical manifestations and coronary artery lesions in patients with coronary heart disease and type 2 diabetes.Methods The enrolled 480 coronary heart disease patients were divided into diabetic group（DM） and non-diabetic group（NDM group）,statistical analysis of risk factors for the two groups of patients,clinical manifestations,complications and angiographic characteristics.Results（1） Comparison of risk factors;Gender differences in the two groups of patients,hypertension,serum levels of TC,LDL-C,positive family history,etc.was not statistically significant（P 0.05）,DM group obesity proportion,serum TG level were more common than NDM group,smoking patients were more common than NDM group（P 0.05）.（2） Clinical manifestations comparison;the proportion of patients with atypical chest pain differences between the two groups of patients was not statistically significant（P 0.05）,myocardial infarction patients in DM group,arrhythmia,heart failure and cardiogenic shock and other complications were more common than NDM group（P 0.05）.（3） Coronary angiography：aspects of LAD,LCX,RCA distribution difference between the two groups were not statistically significant（P 0.05）,DM patients LM,three vascular disease and diffuse lesions were more common than NDM group（P 0.05）.（4） The degree of coronary stenosis in the two groups,2 points compared to 1 point,2 points difference was not statistically significant proportion（P 0.05）,3 points,4 points,5 points differences were significant（P 0.05）.Conclusion Myocardial infarction in diabetic patients with coronary heart disease incidence,clinical complications,diffuse coronary artery disease and severe stenosis more likely to involve the left main.Clinical early intervention of control blood sugar is good for coronary heart disease prevention.