冠心病患者糖代谢与冠脉病变严重程度的关系

目的 了解冠状动脉粥样硬化性心脏病(简称冠心病)患者的糖代谢状况并探讨糖耐量变化与冠状动脉病变严重程度的关系.方法 207例冠状动脉造影阳性的冠心病患者根据美国糖尿病学会(1997年)糖尿病诊断标准分为A组正常糖耐量(NGT)患者100例;B组糖耐量下降(IGT)患者47例;合并糖尿病(DM)患者(C组)60例,所有患者均测定空腹血糖、餐后2小时血糖、甘油三酯、总胆固醇、低密度脂蛋白、高密度脂蛋白,比较冠状动脉造影的受累情况. 结果 207例冠心病患者合并糖代谢紊乱51.68%;冠状动脉病变C组双支、三支病变发生率(36.67%、46.67%)高于B组(29.79%、31.91%)和A组(28.24%、31.21%)(P＜0.05);C组单支病变发生率(16.66%)低于B组(38.30%)、A组(38.55%)P＜0.05);而B组与A组差异无统计学意义(p＞0.05).冠脉病变程度c组与其他两组差异有统计学意义(P＜0.05);而B组与A组差异无统计学意义(P＞0.05).C组弥漫性病变发生率,(63.33%)高于其他两组,差异有统计学意义(P＜0.05),而B组(36.17%)与A组(42.00%)差异无统计学意义(P＞0.05). 结论 冠心病患者糖代谢异常发生率高,合并糖尿病的冠心病患者冠状动脉病变多支病变发生率高,病变更严重、弥漫,但糖耐量下降并不影响冠脉多支病变发生率和冠脉病变严重程度.

The relationship between glucose tolerance and severity of coronary artery lesions in patients with coronary heart disease

Objective To elucidate the relationship between glucose tolerance and the severity of coronary artery lesions in patients with coronary heart disease. Methods Two hundred and seven patients with coronary heart disease were divided into 3 groups: 100 cases with normal glucose tolerance(NGT, group A) ; 47 cases with impaired glucose tolerance (IGT, group B); 60 cases with diabetes mellitus (DM, group C). All patients underwent coronary angiography and blood tests for fast blood glucose (FBG), postprandial 2h blood glucose (p2hBG), cholesterol(CHO), triglyceride (TG), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL). Results In 207 cases, patients coexisting glucose metabolic disorders account for 51.68%. The incidence of double and triple vessel lesions in group C(36.67% and 46.67%) were significantly higher than those in group B (29.79% and 31.91%) and group A (28.24% and 31.21%) (P<0.05). There were no significant differences between group A and group B. Coronary artery lesion of group C was severer than that of group A and group B(P<0.05) , but there was no significant difference between group A and group B. Diffuse lesion was more frequent in group C (63.33%) than group A(42.00%)and group B(36.17%)(P<0.05) , also there was no significant difference between group A and group B. Conclusion The frequency of abnormal glucose metabolism is considerable high in patients with coronary heart disease. The coronary multivessel lesions and severe lesions and diffuse stenosis are more frequent in patients with diabetes mellitus.