无心脏症状老年糖尿病患者冠脉病变观察  

作　　者：王萍[1] 张敏[1] 叶晓梅[1] 曹含弘[1] 金海英[1] 

机构地区：[1]复旦大学附属中山医院青浦分院,上海201700

出　　处：《世界中医药》2016年第B03期1125-1126,共2页World Chinese Medicine

摘　　要：目的了解无心脏症状老年糖尿病患者冠状动脉病变的情况，并探讨对其的评估方法。方法：选择30例糖尿病患者进行16层螺旋cT检查，排除有心前区闷痛主诉或明确有冠状动脉病变的患者。结果：20例发现存在冠状动脉病变，单支病变者5例，多支病变15例。对病变组和正常组进行统计分析，发现病变组的年龄、空腹血糖、HBAIC明显高于正常组（P=0．0106、0．0158、0．0008）。但两组间糖尿病病程无明显差别（P=0．2201）。另外两组的外周动脉病变发生率明显不同（P=0．01），尤其颈动脉病变有显著性差异（P=0．0016）。任选其中9人行冠脉造影，其结果与冠脉CT的结果无显著性差异（p〉0．05）。结论：长期血糖控制不佳的老年糖尿病患者，即使无心脏症状，可能已出现严重的弥漫性冠脉病变。外周动脉病变尤其是颈动脉病变可作为提示作用。冠脉cT对冠脉病变的早期诊断有重要临床价值。Objective To acknowledge charactestics of coronary artery lesions in old asympotic diabetic patients and to investigate the method of evaluting slient coronary disease.Methods：30 cases were enrolled, and those who complained of pain in heart front area or had been already diagnosed coronary disease definitely were excluded.Each was examed by 16-slice CT.Subjects would be devided into two groups, coronary disease group and normal group,according to the resuhs of the 16 slice CT.Results：Coranary lesions were found in 20 cases and 2/3 were muhivessal changes. Analysis of the two groups demonstrated that age,fasting glucose,HbA1C were significantly higher in disease group （P=0.0106,0.0158,0.0008）,but there was no significant difference is the history of diabetic mellitus （P=0.2201）. The presence of peripheral arteriopathy were significantly different between the two group （P=0.01）,especially the ,carotid arteriopathy （P=0.0016）,CQronarography was performed in 9 subjects and the resuhs were not significantly different from the CT yeslts （P〉0.05）.Conclusion：Severe mlAtivessal coronary diseases maybe already present in those asymptomi old patients with diabetic mellitus especially in those glucose are not controlled well and peripheral arteriopathy could be a predictor. The investigation using 16 slice CT has very important clinical value to early diagnosis of coronary artery damage in patients with diabetic mellitus.

关 键 词：糖尿病 冠脉病变 体层摄影术 X线计算机 

分 类 号：R541[医药卫生—心血管疾病]