老年冠心病伴2型糖尿病患者临床相关危险因素及冠状动脉造影特点分析  

Clinical characteristics and coronary angiographic findings in elderly coronary heart disease patients with type 2 diabetes mellitus

作　　者：王丽[1] 陈庆伟[1] 吴庆[1] 柯大智[1] 况刚[1] 

机构地区：[1]重庆医科大学附属第二医院老年心血管内科,重庆400010

出　　处：《中华老年多器官疾病杂志》2013年第3期168-171,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：国家自然科学基金面上项目（No.31271262）

摘　　要：目的探讨老年冠心病伴2型糖尿病患者临床相关危险因素及冠状动脉造影特点。方法471例经冠状动脉造影确诊的老年冠心病（年龄≥60岁）患者，将其分为冠心病伴2型糖尿病组（179例），单纯冠心病组（292例）。对比分析两组患者临床相关危险因素及冠状动脉造影资料。结果多因素非条件的logistic回归分析显示，低密度脂蛋白胆固醇（LDL—C）、空腹血糖（FBG）、餐后2h血糖（2hPBG）是2型糖尿病并发冠心病的独立危险因素（P≤0．001）。与单纯冠心病组相比较，冠心病伴2型糖尿病组发生3支病变较多（P〈0．01）、冠状动脉重度狭窄、完全闭塞及弥漫病变比例更高（P〈0．01），其Gensini积分亦显著高于单纯冠心病组（P=0．009）。结论LDL-C、FBG及2hPBG是老年2型糖尿病并发冠心病的独立危险因素，老年冠心病伴2型糖尿病患者冠状动脉累及范围广且程度重。Objective To explore the clinical characteristics and coronary angiographic findings in elderly coronary heart disease （CHD） patients with type 2 diabetes mellitus （T2DM） Methods A total of 47l patients （age〉60 years） with angiographically diagnosed CHD were divided into 2 groups： 179 CHD patients with T2DM and 292 CHD patients without T2DM. The data of the clinical features and selective coronary angiographics were compared between the two groups. Results Multivariate unconditional logistic regression analysis showed that low density lipoprotein cholesterol （LDL-C）, fasting blood glucose（FBG） and 2h post blood glucose （2hPBG） were independently correlated with CHD patients with T2DM （P〈0.001）. Compared to CHD patients without T2DM, CHD patients with T2DM suffered much more from triple vessels lesions （P 〈 0.010）, severe coronary artery stenosis, complete occlusions and diffuse lesions （all P〈 0.01）, and their Gensini scores were higher （P= 0.009）. Conclusions The risk factors of LDL-C, FBG and 2hPBG are independently correlated with CHD patients with T2DM. Diffuse and severe lesions are more common in elderly CHD patients with T2DM.

关 键 词：老年人 冠状动脉疾病 糖尿病 2型 冠状动脉造影 

分 类 号：R541.4[医药卫生—心血管疾病]