糖尿病患者颈股脉搏波传导速度与冠脉病变严重程度的关系

目的探讨糖尿病患者颈股脉搏波速度（cfPWV）与冠状动脉狭窄程度积分（Gensini）的相关性及特点，为临床进一步广泛应用提供依据。方法入选疑诊冠心病并行冠脉造影术患者160例，其中男性82例，女性78例，年龄40-78（55±10）岁，分为四组：A组（无糖尿病及冠心病，对照组）、B组（无糖尿病有冠心病）、C组（有糖尿病无冠心病）和D组（糖尿病合并冠心病），每组各40例。检测患者cfPWV；冠脉病变严重程度根据美国心脏协会制定的Gensini评分系统对每支血管病变程度进行定量评定；cfPWV与年龄、血脂、血压、Gensini积分分别进行相关分析。结果四组患者间年龄、性别、吸烟率、BMI、HDL—C差异无统计学意义（P〉0．05），脉压、TG、TC及LDL—C差异有统计学意义（P〈0．05）。四组患者间收缩压及舒张压差异有统计学意义（P〈0．01）。D组cfPWV最快，与其他三组相比差异有统计学意义（P〈O．05）；B组与C组cfPWV比较差异无统计学意义（P〉0．05）；B组与C组cfPWV均大于A组，差异有统计学意义（P〈0．05）。B组与C组Gensini积分比较差异有统计学意义（P〈0．05）；D组Gensini积分明显高于其他三组，差异有统计学意义（P〈0．05）；B组明显高于A组和c组（P〈0．05），A组与C组差异无统计学意义（P〉0．05）。cfPWV与年龄、收缩压、舒张压、Gensini积分呈正相关（相关系数分别为0．231、0．229、0．281和0．348，P均〈0．05）。D组患者cfPWV与Gensini积分呈正相关（r=0．408，P〈0．叭）；D组Gensini积分明显高于B组，差异有统计学意义（P〈0．01）。结论糖尿病合并冠心病组的cfPWV和Gensini积分明显增高。cfPWV与Gensini积分呈正相关，cfPWV可作为一项预测冠状动脉病变严重程度的无创性检查指标。

The study of the correlation between carotid-femoral pulse wave velocity and severity of coronary artery in patients with diabetes

Objective To evaluate the correlation of carotid-femoral pulse wave velocity （cfPWV） and severity of coronary artery in patients with diabetes. Methods One hundred and sixty consecutive patients with diabetes （82 male, 78 female, mean age： 55±10 years） were prospectively included in this study. The subjects were divided into four groups： the group A was control group, while group B included pateints who have coronary artery disease and group C was diabetes mellitus disease group and group D enrolled patients with coronary artery disease combined with diabetes mellitus. Each group has 40 cases. The body mass index （BMI）, blood fat and cf- PWV were examined. The severity of coronary artery angiography of patients was calculated by Gensini integral. Results The levels of age, gender, smoking rate, BMI, high density lipoprotein-cholesterol（HDL-C） in the four groups have no significant differences（P〈0.05 ）. The levels of pulse pressure（PP）, triglyceride（TG）, total choles- terol （TCH） and low density lipoprotein-cholesterol （LDL-C） in four groups have significant difference（P〈0.05 ）. The levels of systolic blood pressure and diastolic blood pressure in four groups have significant difference （P〈 0.01 ）. The levels of cfPWV, Gensini score in group D were significantly higher than those in other groups （P〈 0.05）. The levels of cfPWV, Gensini score in group B and C were significantly higher than those in group A （P〈0.05）. The levels of Gensini score in group B were significantly higher than those in group C （P〈0.05）. The levels of cfPWV in group B have no statistics difference than those in group C （P〉0.05）. In all patients, cfPWV and age, systolic blood pressure, diastolic blood pressure, Gensini score were positively correlated. There were posi- tively correlated between cfPWV and Gensini score in patients with diabetes mellitus combined coronary heart dis- ease group. Conclusion The cfPWV and Gensini score are significantly higher in patients with diabetes mellitus combined coronary heart disease. There are positively correlated between cfPW~ and Gensini score. The cfPWV can be used to be a method to evaluate the severity of these patients.