摘要
目的 探讨糖尿病前期冠脉病变的特点及危险因素。方法 193例冠心病患者根据 1997年美国糖尿病学会诊断标准分为单纯冠心病组 12 2例 ,冠心病合并糖耐量异常组 39例 ,冠心病合并糖尿病组 32例 ,所有研究对象均行冠脉造影和口服 75 g葡萄糖耐量实验 ,检测血糖、胰岛素、血脂、血压、BUN、Cr。冠脉病变程度应用 CAG分析 ,冠脉狭窄程度根据 AHA分类标准评价 ,冠脉病变的危险因素应用多元逐步直线回归分析。结果 (1)冠心病合并糖耐量异常组多支冠脉病变的发生率明显高于单纯冠心病组 (6 6 .5 % vs 35 .1% ,P <0 .0 5 )。冠脉狭窄程度 (8.9± 3.6 vs 6 .5± 3.9,P<0 .0 5 )及钙化的程度明显高于单纯冠心病组 (6 .6± 6 .1vs 3.9± 4 .1,P <0 .0 5 ) ,冠脉远端的病变发生率明显高于单纯冠心病组 (40 .8% vs 13.1% ,P <0 .0 5 )。 (2 )冠心病合并糖耐量异常组与冠心病合并糖尿病组相比 ,多支冠脉病变的发生率、冠脉粥样硬化及钙化的程度及冠脉远端的病变发生率差异性不明显。(3)血脂、胰岛素、血压、肥胖与冠脉粥样硬化程度有明显相关性。结论 与糖尿病患者相似 ,糖耐量异常患者多支冠脉病变的发生率明显升高 ,病变多呈弥漫性狭窄 ,远端血管病变发生率较高 ,程度严重 ,血脂、胰岛素、血压。
Objective To investigate the character and risk factors of coronary artery disease in prediabetes. Methods The 193 patients with coronary artery disease were divided into 3 groups according to the American diabetes associations (ADA) standard of diabetic diagnoses. (1) Normal glucose tolerance group(NGT group,122 cases). (2) Impaired glucose tolerance group (IGT group,39 cases). (3) Diabetes mellitus group (DM group,32 cases). All patients were checked by the coronary angiographic semiquantitative (CAG) and the 75g oral glucose tolerance test. Blood glucose, insulin, TG, TC, HDL C, blood pressure, BUN and Cr were determined. The coronary artery changes were analysed by CAG, and the severity of coronary artery stenosis were evaluated by AHA standards. The risk factors in coronary artery disease were analysed by pluralized straight line statistics. Results The coronary multivessel changes and the severity of coronary artery stenosis and calcification were more frequent in IGT group than in NGT group (66 5% vs 35 1%,8 9±3 6 vs 6 5±3 9,6 6±6 1 vs 3 9±4 1,P<0 05). Distal coronary changes were more frequent in IGT group than in NGT group. There were no significantly difference between IGT and DM group.The levels of Lipid(TG and TC and HDL C), insulin, blood pressure and obesity are associated with the coronary artery disease. Conclusion There are similar morbidity and severity of coronary artery disease in IGT and DM group.The coronary artery changes of multivessel, distal coronary and diffusing stenosis are more frequent in IGT or DM group than in NGT group. These results suggest that blood Lipid, insulin, blood pressure and obesity are an independent risk factors for coronary artery disease in patients with impaired glucose tolerance.
出处
《中国糖尿病杂志》
CAS
CSCD
2002年第2期104-107,共4页
Chinese Journal of Diabetes
基金
国家教委归国留学人员课题 (980 56)
