冠心病合并2型糖尿病患者不稳定动脉粥样硬化斑块的评估及影响因素的分析  

Analysis of influencing factor and evaluation of unstable plaque in patients suffered from coronary heart disease

作　　者：孙百超[1] 杨东辉[1] 王越晖[1] 刘斌[1] 

机构地区：[1]吉林大学第二医院心血管内科,吉林长春130041

出　　处：《中国实验诊断学》2013年第4期683-686,共4页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省国际科技合作项目(2010728);教育部高校博士点基金项目(20100061110066)

摘　　要：目的研究合并2型糖尿病的冠状动脉粥样硬化性心脏病(冠心病)患者与非2型糖尿病冠心病患者的不稳定动脉粥样硬化斑块的差别。方法在行冠脉造影术时,通过血管内超声(IVUS)对146例冠心病患者病变血管进行检测,测定是否有不稳定粥样硬化斑块,并评估冠脉狭窄程度。根据患者是否存在糖尿病,分为2组进行对比,同时定量分析患者相关冠心病危险因素:性别、年龄、体质指数(BMI)、高血压、甘油三酯、总胆固醇、低密度脂蛋白胆固醇水平等。结果糖尿病组的不稳定冠状动脉钙化斑块数量显著多于非糖尿病组(P<0.05),糖尿病组的低密度脂蛋白胆固醇水平显著大于非糖尿病组(P<0.05)。结论合并2型糖尿病患者冠脉形成不稳定斑块较非2型糖尿病患者的风险更大,同时2型糖尿病患者的低密度脂蛋白胆固醇水平更高于非2型糖尿病患者。对于同时合并有2型糖尿病的患者在积极控制血糖水平的同时,应积极进行调整血脂治疗,使不稳定斑块向稳定型斑块转化,降低冠脉事件的发生。Objective To analysis the difference of unstable atherosclerotic plaque between coronary atherosclerotic heart disease （CHD） of patients with type 2 diabetes mellitus patients and non type 2 diabetic patients with coronary heart disease difference. Methods During the coronary angiography,by using intravascular ultrasound （IVUS） in 183 cases of coronary heart disease to distinguish the atherosclerotic plaques are unstable and to assess the coronary stenosis. According to whether the patients suffering from Type 2 diabetes, divided them into 2 groups for comparison, quan- titative analysis of risk factors with coronary heart disease：gender, age, body mass index （BMI）, high blood pressure, triglyceride,total cholesterol,low density lipoprotein cholesterol level,etc. Results Type 2 diabetes mellitus group was higher than non-diabetic group with unstable coronary plaque number and degree of coronary artery stenosis （P〈0.05） ,low density lipoprotein cholesterol levels in type 2 diabetic group were significantly higher than non-diabetic group（P〈0.05）. Conclusion patients with type 2 diabetes have a greater risk of coronary artery formation of unstable plaques than patients with nontype 2 diabetes,and low density lipoprotein cholesterol levels in patients with type 2 diabetes is higher than that of patients with type 2 diabetes mellitus.

关 键 词：冠心病 不稳定斑块 血管内超声 2型糖尿病 血脂异常 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]