糖代谢异常冠心病患者的冠状动脉造影特点  

Coronary angiographic findings in patients with glucometabolic abnormality and coronary heart disease

作　　者：李勇[1,2] 赖晓阳[1] 

机构地区：[1]南昌大学第二附属医院内分泌代谢科,330006 [2]广州市花都区人民医院内分泌科

出　　处：《中国糖尿病杂志》2012年第10期751-754,共4页Chinese Journal of Diabetes

摘　　要：目的分析糖代谢异常合并冠心病(CAD)患者的冠状动脉造影(CAG)特点。方法选取CAG确诊为CAD的未知血糖患者130例,对所有患者完成血压、血糖、FIns、血脂、体脂参数等测定。根据75g OGTT结果,分为糖耐量正常(NGT)组、负荷后2hIGT组和新诊断糖尿病(DM)组,比较分析其冠状动脉影像学的特点。结果 IGT组和DM组冠状动脉病变支数、重度狭窄(77.5%和78.4%vs56.6%)、弥漫性病变(40.0%和40.5%vs 17.0%)、右冠状动脉病变比例(67.5%和64.9%vs 41.5%)、病变总积分[(5.275±1.768)和(5.865±2.720)vs(4.132±1.765)]均高于NGT组(P<0.05或P<0.01);2hPG、胰岛素抵抗指数(HOMA-IR)、WHR、载脂蛋白B(ApoB)、吸烟史、BMI、高血压病、CAD家族史是CAD的独立预测因素(P<0.01)。结论糖代谢异常患者冠状动脉病变的严重程度,随着糖代谢异常的加重而加剧,在糖尿病前期已有凸显。Objective To analyze the characteristics of coronary angiographic（CAG） findings in patients with glucometabolic abnormality and coronary heart disease（CAD）.Methods A total of 130 patients with CAD confirmed by CAG were included in this study.The blood pressure,blood glucose,fasting insulin（FIns）,serum lipid profile,and body mass index（BMI） of all patients were determined.According to the result of 75g OGTT,they were divided into 3 groups： normal glucose tolerance（NGT）,impaired glucose tolerance（IGT）,and diabetes mellitus（DM） respectively for comparing the characteristics of CAG findings.Results Compared with the NGT patients,the IGT and DM patients suffered from more multiple vessel lesions,severe coronary artery stenosis（77.5% and 78.4% vs 56.6%）,diffuse lesions（40.0% and 40.5% vs 17%）,the right coronary artery（RCA） lesions（67.5% and 64.9% vs 41.5%）,and the cumulative scores [（5.275±1.768） and（5.865±2.720） vs（4.132±1.765）]（P〈0.05 or P〈0.01）.The 2 hour plasma glucose（2 hPG）,insulin resistance index（HOMA-IR）,waist-to-hip rate（WHR）,apo-lipoprotein B（Apo-B）,smoking,BMI,hypertension,family history of CAD were the independent factors of predicting CAD（P〈0.01）.Conclusions The coronary artery lesions are getting worse with the progress of glucometabolic abnormality,and this phenomenon may present in the impaired glucose tolerance period

关 键 词：冠心病 糖代谢异常 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]