2型糖尿病患者冠心病冠脉造影与心电图特点分析  

The analysis of angiographic characteristics of the coronary artery disease in patients with type 2 diabetes mellitus

作　　者：李文华[1] 刘玲玲[2] 宫建丽[1] 孔香云[1] 张秀州[1] 唐元升[1] 朱兴雷[1] 

机构地区：[1]山东省立医院老年及心血管内科,山东济南250021 [2]山东省立医院检验科,山东济南250021

出　　处：《医学影像学杂志》2006年第8期790-792,共3页Journal of Medical Imaging

基　　金：2003-山东省科技发展计划35号

摘　　要：目的:探讨2型糖尿病患者冠心病冠脉造影及心电图特点。方法:203例患者按照冠心病的临床分类分为心梗组与非心梗组,对冠脉造影及心电图结果进行分析。结果:心梗组患者冠脉造影狭窄血管总数明显高于非心梗组(62.8%对53.3%,P<0.01),且三支血管病变多(50.0%对26.5%,P<0.01),病变血管完全闭塞比例高(23.0%对12.4%,P<0.01);而单支血管病变(14.4%对28.3%,P<0.05)和血管狭窄程度<50%的比例(4.9%对14.1%,P<0.01)均低于非心梗组。两组之间的狭窄病变分布部位,弥漫受累血管总数,弥漫病变分布部位及各分支弥漫受累比例差异均无统计学意义。心电图分析结果示心梗组的病理性Q波出现率明显高于非心梗组(67.8%8%对19.5%,P<0.01)且T波倒置多(74.4%对59.3%,P<0.05)而ST段改变两组差异无显著性意义(43.3%对46.9%,P>0.01)。结论:2型糖尿病冠心病在冠脉造影上心梗组较非心梗组冠状动脉狭窄病变支数多及其狭窄程度严重,病变的分布部位及弥漫性受累血管总数差异不显著。心电图是2型糖尿病冠心病的一种简单有效的筛选方法,但存在一定的假阳性率和假阴性率。Objective：To study the angiographic and electrocardiographic characteristics of coronary artery disease （CAD） in patients with type 2 diabetes mellitus.Methods：The study was carried by the analysis of the data from cine selective coronary angiography and electrocardiography in 203 CAD patients with type 2 diabetes mellitus in the two groups divided by different manifestations. Results：The myoeadial infarction group（MI） has more narrow-involved vessels （62.8% vs 53.3%, P 〈0.01）, more three narrow-involved vessels （50.0% vs26.5%, P 〈0.01） and more completed-obstructive vessels （23.0%vs12.4%, P 〈0.01） , but the one-branch narrow vessels （ 14.4 % vs 28.3 %, P 〈 0.05） and narrow degree 〈 50 % vessels （4.9 % vs 14.1%, P 〈 0.01 ） were less than the non-myocardial infarction group. But the difference in the position of narrow lesions, the total involved vessels of diffuse lesions, the position of diffuse lesions and the involved degree of the branches of coronary between the two groups was not significant. The analysis of electrocardiography （ECG） suggested myocardial infarction group had more pathologic Q pulse （67.8% vs 19.5%, P 〈0.01 ） and more inversire T wave （74.4% vs 59.3%, P 〈 0.05）, but the difference in the change of ST between the two groups was not significant. Conclusion： Different types of CHD with type 2 diabetes mellitus patients were different in narrow vessels and the narrow degree of the lesions on the coronary angiography . But the difference in the position of lesions and the diffuse lesions was not significant. Electrocardiography was an effective method to the diagnosis of CAD with type 2 diabetes mellitus, but it had a certain false positive and false negative rate.

关 键 词：冠心病 糖尿病 非胰岛素依赖型 冠状动脉造影术 心电图 

分 类 号：R541.4[医药卫生—心血管疾病] R815[医药卫生—内科学]