冠心病合并糖代谢异常患者的临床研究

目的分析冠心病合并糖代谢异常患者的冠状动脉病变特点和糖代谢异常对经皮冠状动脉介入治疗(PCI)操作及住院期不良事件的影响。方法对184例糖代谢异常及147例糖代谢正常的冠心病患者进行回顾性分析。分析患者的冠状动脉病变特点,计算血管造影成功率、操作成功率以及临床成功率,分析糖代谢异常对住院期临床事件的影响。结果糖代谢异常组患者多支病变检出率明显高于糖代谢正常组患者,冠状动脉病变范围更广泛、程度更重、病变更复杂,更易累及小血管(P<0.05)。糖代谢异常组与糖代谢正常组之间的血管造影成功率、操作成功率和临床成功率差异无统计学意义(分别为91.8%vs.93.9%,88.0%vs.91.8%及85.3%vs.90.5%,P均>0.05)。Logistic多元回归分析显示糖代谢异常不是PCI术住院期发生不良事件的独立危险因素(OR=0.999,95%IC:0.242~9.172,P>0.05)。结论糖代谢异常患者冠状动脉病变比糖代谢正常患者更复杂、严重;糖代谢异常不是PCI术住院期发生不良事件的独立危险因素。

Clinical study of patients with coronary heart disease and abnormal glucose metabolism

Objective To analyze coronary angiographic findings in patients with coronary heart disease(CHD) and abnormal glucose metabolism and to evaluate the influence of abnormal glucose metabolism on PCI and in-hospital outcomes.Methods One hundred and eighty-four patients with abnormal glucose metabolism and 147 patients with normal glucose metabolism were analyzed retrospectively.Baseline demographics and coronary angiographic findings in both groups were analyzed.Rates of angiographic success,procedural success and clinical success were analyzed and Logistic regression was performed to model the association between abnormal glucose metabolism status and clinical outcomes. Results Multi-vessel diseases were more prevalent in patients with abnormal glucose metabolism than in patients with normal glucose metabolism.Vessel lesions in patients with abnormal glucose metabolism were more diffuse,severe and complex and more small vessels involved than those in patients with normal glucose metabolism(P<0.05).The angiography success rate,procedural success rate and clinical success rate showed no significant difference between the two groups(91.8% vs.93.9%,88.0% vs.91.8% and 85.3% vs.90.5% respectively,all P>0.05).Logistic regression analysis showed that abnormal glucose metabolism was not an independent predictor of in-hospital events for patients having received PCI(OR=0.999,95%IC: 0.242~9.172,P>0.05). Conclusions Coronary artery lesions in patients with abnormal glucose metabolism are more severe and complicated than those in patients with normal glucose metabolism.Abnormal glucose metabolism is not an independent predictor of adverse in-hospital outcomes in patients who underwent PCI.