摘要
目的 了解糖尿病 (DM )合并急性冠状动脉综合征 (ACS)患者冠状动脉病变的特征。 方法 冠心病监护病房收治的 38例空腹血糖≥ 7 0mmol/L的ACS患者 (DM组 ) ,同期选择与之性别、年龄 (± 2岁 )、吸烟、高血压、心脏肌钙蛋白和心肌梗死史相匹配的糖耐量正常的 4 7例作为对照的ACS患者 (NDM组 ) ,分别对两组进行冠状动脉造影分析及比较。 结果 (1)血纤维蛋白原、空腹血糖、胆固醇、甘油三酯和低密度脂蛋白胆固醇浓度DM组较NDM组高 (P均 <0 0 5 ) ;而高密度脂蛋白胆固醇DM组较NDM组低 (P <0 0 5 )。 (2 )DM组较NDM组冠状动脉单支病变发生率低(2 3 4 0 %与 4 4 6 8%比 ,P <0 0 5 ) ;而多支病变的发生率高 (4 4 73%与 19 19%比 ,P <0 0 5 )。 结论 DM合并ACS患者的冠状动脉病变范围广泛 ,DM发生ACS是多因素协同的结果。
Objective The purpose of this study was to determine coronary artery pathological changes in diabetic patients with acute coronary syndromes(ACS). Methods 38 patients with ACS and fasting plasma glucose ≥ 7.0 mmol/ L (DM group)were enrolled. In the same period 47 controls with ACS and normal FPG (NDM group) matched with DM group on sex ,age range (+2 yrs), smoke cigarette ,serum cardiac troponin ,hypertension and myocardial infarction history.The contrast analysis of tow groups was done by coronary angiographic findings. Results ①The levels of serum fibrinogen, blood glucose and serum lipid in DM group were markedly higher than in NDM group(P<0.05).② Compared with NDM group, DM group had more extensive coronary artery disease and was more likely to have triple vessel coronary artery disease (44.73%比19.19%,P<0.05). DM group patients with ACS were less likely to have single coronary artery pathological changes (23.40%比44.68%,P<0.05) compared with NDM group. Conclusions The coronary artery pathological changes in ACS diabetics are extensive. ACS of DM comes from multi-factors conjunction.
