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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 angiography (CAG) in patients with abnormal glucose metabolism and coronary heart disease (CAD). Methods A total of 130 unknown patients with CAG diagnosed with CAD were enrolled in this study. Blood pressure, blood glucose, FIns, lipids and body fat parameters were measured in all patients. According to the 75g OGTT results, they were divided into two groups: normal glucose tolerance group (NGT) group, 2hIGT group and newly diagnosed DM group. The characteristics of coronary angiography were compared. Results The number of coronary lesions, severe stenosis (77.5% vs 78.4% vs 56.6%), diffuse lesions (40.0% vs 40.5% vs 17.0%), right coronary lesions (67.5% vs 64.9%) in IGT group and DM group % vs 41.5%). The total score of the lesions was significantly higher than that of the NGT group [(5.275 ± 1.768) vs (5.865 ± 2.720) vs (4.132 ± 1.765) vs NGT group, P <0.05 or P <0.01) -IR), WHR, apolipoprotein B (ApoB), smoking history, BMI, hypertension and family history of CAD were independent predictors of CAD (P <0.01). Conclusions The severity of coronary lesions in patients with abnormal glucose metabolism aggravates with the aggravation of abnormal glucose metabolism and has been highlighted in pre-diabetes.