2型糖尿病合并冠心病患者冠状动脉影像学特点和心功能的变化  

Angiographic status of coronary arterial disease and changes of heart function in patients with type 2 diabetes mellitus

作　　者：冯波[1] 王元元[1] 张代富[2] 

机构地区：[1]同济大学附属东方医院内分泌科,上海200120 [2]同济大学附属东方医院心内科,上海200120

出　　处：《临床内科杂志》2007年第12期811-813,共3页Journal of Clinical Internal Medicine

摘　　要：目的观察2型糖尿病合并冠心病患者冠状动脉病变影像学特点和心功能变化。方法经选择性冠状动脉造影确诊冠心病419例,其中2型糖尿病患者161例(DM组),非糖尿病患者258例(非DM组),采用积分法评估两组冠脉病变狭窄程度和范围,利用心脏超声法检测左心室收缩期射血分数。结果DM组Gensini积分和范围积分明显高于非DM组,差异有统计学意义。非DM组以单支血管病变为主,而DM组三支病变明显增多。DM组心脏射血分数(EF)较非DM组明显降低。多元逐步回归分析显示冠心病患者Gensini积分和空腹血糖和LDL-C/HDL比值有明显相关关系。结论2型糖尿病合并冠心病患者冠状动脉病变的狭窄程度和病变范围较非糖尿病患者明显和严重,且伴有心功能明显降低,空腹血糖水平、LDL-C/HDL比值能预测冠心病患者冠状动脉病变程度。Objective To investigate the angiographic distribution characters of coronary arterial disease and changes of heart function in type 2 diabetics with CAD. Methods Angiographies of coronary arteries were performed in 161 type 2 diabetics （ diabetic group） and 258 non-diabetics （ non-diabetic group） who had coronary arterial disease （CAD）. The severity and extension of coronary arterial angiography were evaluated by scores, and left ventricle systolic ejection fraction was measured using ultrasonic echocardiogram. Results Gensini scores and extension scores were significant increased in DM group compared with that in non-DM group. There was significant higher incidence of single vascular lesion in non-diabetics,however more triple vascular lesion in diabetics. There was significant decrease in EF value in DM group compared with that in non-DM group. Stepwise regression analysis showed that fasting blood glucose level and the ratio of LDL-C to HDL-C were associated with Gensini scores in patients with CAD. Conclusions Compared to non-dlabetlcs with CAD, there are more severe and extensive coronary arterial lesions in type 2 diabetics with CAD. There is significant decrease in heart function. Fasting blood glucose level and ratio of LDL-C to HDL-C could predict status of coronary arterial lesion in CAD.

关 键 词：冠心病 糖尿病 冠状动脉造影 超声心动图 

分 类 号：R587.1[医药卫生—内分泌] R541.4[医药卫生—内科学]