严重冠脉狭窄合并2型糖尿病患者侧支循环形成的影响因素  

Influencing Factors of the Formation of Collateral Circulation in Patients with Severe Coronary Stenosis and Type 2 Diabetes

作　　者：杜茂宗 姚海木[1] DU Mao-zong;YAO Hai-mu(Department of Cardiology,the First Affiliatied Hospital of Zhengzhou University,zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院心血管科,河南郑州450000

出　　处：《河南医学研究》2020年第6期984-987,共4页Henan Medical Research

摘　　要：目的探讨严重冠脉狭窄合并2型糖尿病患者的冠脉侧支循环(CCC)的影响因素。方法选择主要冠脉血管狭窄≥95%合并2型糖尿病的患者320例,根据冠脉造影结果分为CCC良好组和CCC不良组。记录临床及造影资料,分析CCC形成的影响因素。结果 320例患者中良好侧支循环83例,占25.9%。Logistic回归分析显示较长的心绞痛病程、完全闭塞病变及较高淋巴细胞计数是良好冠脉侧支形成的有利因素,较高的中性粒细胞计数、较高的中性粒细胞/淋巴细胞比值(NLR)、急性心肌梗死与CCC不良相关(均P<0.05)。结论严重冠脉狭窄合并2型糖尿病患者CCC较差,长心绞痛病程、完全闭塞病变有利于良好的冠脉侧支循环形成,而急性心肌梗死及高NLR是CCC形成的不利因素,未发现空腹血糖、糖化血红蛋白水平与CCC形成明显相关。Objective To investigate the influencing factors of coronary collateral circulation(CCC) in patients with severe coronary stenosis complicated with type 2 diabetes mellitus.Methods Three hundred and twenty patients with major coronary artery stenosis≥95% complicated with type 2 diabetes mellitus were divided into good CCC group and poor CCC group according to the results of coronary angiography. Clinical and radiographic data were recorded to analyze the influencing factors of CCC.Results There were 83 cases of good collateral circulation in 320 patients, accounting for 25.9%. Logistic regression analysis showed that the longer duration of angina, total occluded lesion and high lymphocyte count had a good effect on CCC, higher neutrophil count, higher neutrophil-lymphocyte ratio(NLR)and acute myocardial infarction were correlated with poor CCC(all P<0.05).Conclusion CCC is poor in patients with severe conorary stenosis complicated with type 2 diabetes, long angina pectoris course, complete occlusion lesions and high lymphocyte count were conducive to the formation of good CCC, while high NLR and acute myocardial infarction were adverse factors for formation of CCC, and no significant correlation was found between fasting blood glucose and glycated hemoglobin and the formation of CCC.

关 键 词：冠脉狭窄 2型糖尿病 冠状动脉侧支循环 

分 类 号：R541.6[医药卫生—心血管疾病]