422例患者冠状动脉造影检查的临床资料分析

目的：探讨糖尿病患者血脂谱与尿酸代谢特点并寻找冠状动脉粥样硬化病变的独立危险因素。方法回顾性分析2012年1月至2013年4月在我院住院的422例接受CAG检查患者临床资料，其中66例合并2型糖尿病纳入糖尿病组，356例无糖尿病归为对照组。根据CAG结果分为冠状动脉正常组（B组），单支病变（A1组）、双支病变（A2组）、多支病变组（A3组）。测定各组血清尿酸、血脂、空腹血糖、糖化血红蛋白水平。结果糖尿病组与对照组相比，年龄、性别、血清TC、LDL及HDL水平无明显差异（P〉0.05），血清UA、TG、FBS、HbA1c均较对照组升高（P〈0.05）。糖尿病组合并高血压病、高三酰甘油血症及高尿酸血症比例均较对照组显著增高（P〈0.01）。Spearman秩相关分析显示冠状动脉粥样硬化病变程度与糖尿病相关（P=0.001），糖尿病组冠状动脉病变更弥漫。二项分类Logistic回归分析显示男性（OR=2.421，95%CI1.576～3.718，P=0.000）、高三酰甘油血症（OR=1.749，95%CI1.071～2.856，P=0.025）及高尿酸血症（OR=1.719，95%CI1.076～2.744，P=0.023）均为冠状动脉粥样硬化病变的独立危险因素。结论糖尿病患者合并高血压病、血脂代谢紊乱、高尿酸血症发生率较非糖尿病患者高，冠状动脉粥样硬化病变更弥漫，男性、高三酰甘油血症及高尿酸血症均为冠状动脉粥样硬化病变的独立危险因素。

Clinical Analysis of 422 Inpatients who Underwent Coronary Angiography

Objective The incidence and prevalence of type 2 diabetes mellitus continue to escalate globally at alarming rates. Our study aim to investigate the lipid proifle components and uric acid in patients with type 2 diabetes and to ifnd out coronary atherosclerosis independent risk factors. Methods This observational cohort study recruited for 422 patients hospitalized from January 2012 to April 2013 underwent coronary angiography（CAG） .There were 66 cases of T2DM and 356 cases of normal glucose tolerance were divided into 4 groups according to CAG,B group：Non-CAD, A1 group：one diseased branche arterial, A2 group：double vessel lesions,A3 group：several diseased branches arterial.All biochemical analysis were assessed by local laboratories using standard laboratory methods. Results No significant difference of age, sex, serum total cholesterol, low-density lipoprotein and high-density lipoprotein was observed between the control group and diabetes group（P〉0.05）, while the serum uric acid level, triglyceride,fasting blood-glucose and hemoglobin A1c of diabetes group were signiifcantly higher than that of control group（P〈0.05）. The incidence of hypertension , hypertriglyceridemia and hyperuricemia was markedly higher of diabetes group than that of control group（P〈0.01） . The degree of coronary atherosclerosis was positively correlated with diabetes（P=0.001）, coronary atherosclerosis lesions were more diffuse in diabetes group . In binary logistic regression analysis, we found that male（OR=2.421, 95%CI1.576~3.718, P=0.000）, hypertriglyceridemia（OR=1.749, 95%CI1.071~2.856, P=0.025）and hyperuricemia （OR=1.719, 95%CI1.076~2.744, P=0.023）were independent risk factors for coronary atherosclerosis. Conclusions Hypertension, hypertriglyceridemia and hyperuricemia are more common and coronary atherosclerosis lesions were more diffuse in patients with T2DM.Male, hypertriglyceridemia and hyperuricemia were independent risk factors for coronary atherosclerosis .