老年冠心病患者合并糖代谢异常临床观察研究  

Clinical observation and study on senile patients with coronary heart disease complicated with abnormal glucose metabolism

作　　者：蔡琦[1] 顾凯[1] 秦敬莉[1] 王连生[1] 周芳[1] 周蕾[1] 

机构地区：[1]南京医科大学第一附属医院心血管内科,江苏省南京市210029

出　　处：《实用老年医学》2010年第6期460-462,478,共4页Practical Geriatrics

基　　金：2008年江苏省"六大人才高峰"第五批高层次人才项目(苏人通[2008]329号)

摘　　要：目的分析糖代谢异常对老年冠心病患者的影响,探讨餐后2h血糖检测的重要性。方法随机选择经冠脉造影确诊的老年冠心病患者172例,取清晨空腹及餐后2h血糖值后将患者分为糖尿病(DM)组,糖耐量减低(IGT)组,空腹血糖受损(IFG)组和糖耐量正常(NGT)组,比较4组的危险因素及冠脉造影结果。结果 DM组58例(33.72%),IGT组56例(32.56%),IFG组10例(5.81%),NGT组48例(27.91%)。前3组弥漫性病变率、合并血脂异常高于NGT组,差异有统计学意义(P<0.05)。结论老年冠心病合并糖代谢异常患者多支病变及弥漫性病变率高,容易合并其他危险因素,餐后2h血糖测定可提高该类患者检出率。Objective To analyze the influence of abnormal glucose metabolism on the senile patients with coronary heart disease,and to explore the importance of oral glucose tolerance test in this kind of patients.Methods 172 cases of senile patients with coronary heart disease definitely diagnosed by coronary angiography were randomly chosen,then every patient was tested for their fasting plasma glucose and 2 hour plasma glucose.According to the diagnosis and classification criteria of American Diabetes Association,all of the senile patients were divided into the following four groups：diabetes mellitus（DM）group,impaired glucose tolerance（IGT）group,impaired fasting glucose（IFG）group and normal glucose metabolism（NGT）group.The risk factors and the results of coronary angiography were compared.Results In all the 172 patients,there were 58 cases（33.72%）in DM group,56 cases（32.56%）in IGT group,10 cases（5.81%）in IFG group,and 48 cases（27.91%）in NGT group.Compared with normal glucose metabolism group,vessel lesions were more diffuse（P0.05）in patients with abnormal glucose metabolism.Senile patients with coronary heart disease and abnormal glucose metabolism were easy to dyslipidemia.Conclusions Glucose metabolism is an independent risk factor of three-vessel diseases and diffuse vessel diseases of elderly patients with coronary heart disease.Senile patients with both coronary heart disease and abnormal glucose metabolism are vulnerable to other risk factors of coronary arteriosclerosis.The detection rate of this kind of patients can be enhanced by oral glucose tolerance test.

关 键 词：老年人 冠心病 糖代谢异常 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]