目的 探讨冠心病合并2型糖尿病患者冠状动脉病变特征.方法 入选笔者医院2012年6月～ 2014年2月经冠状动脉造影诊断为冠心病的患者213例,根据是否合并2型糖尿病分为2型糖尿病组、非糖尿病组.统计患者入院基本临床资料,所有患者均检测空...目的 探讨冠心病合并2型糖尿病患者冠状动脉病变特征.方法 入选笔者医院2012年6月～ 2014年2月经冠状动脉造影诊断为冠心病的患者213例,根据是否合并2型糖尿病分为2型糖尿病组、非糖尿病组.统计患者入院基本临床资料,所有患者均检测空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）,根据冠状动脉狭窄直径≥50％累及左前降支（LAD）、左回旋支（LCX）、右冠状动脉（RCA）或左主干（LM）分为单支、双支（累及左主干为双支病变）及3支病变组.计量资料采用均数±标准差（x±s）表示,组间比较采用两独立样本t检验,计数资料采用率表示,组间比较用x2检验.结果 冠心病合并2型糖尿病组患者空腹血糖（FPG）比非糖尿病组明显升高（8.45±0.40mmol/L vs 5.61±0.13mmol/L,P＜0.001）,冠状动脉3支病变发生率更高（50.00％ vs 8.94％,P＜0.001）,单支病变、两支/左主干病变发生率低于非糖尿病组（24.4％ vs 48.8％,P＜0.001;25.6％ vs42.3％,P＜0.001）,冠状动脉病变部位更多累及前降支（92.2％ vs 82.1％,P=0.034）、左回旋支（68.9％ vs39.8％,P＜0.001）、右冠状动脉（64.4％ vs 39.0％,P＜0.001）,冠状动脉左主干病变并无统计学意义（7.8％ vs 2.4％,P=0.100）.结论 冠心病合并2型糖尿病患者冠状动脉病变更为广泛、严重,具有更高的致死风险.展开更多
This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular ris...This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.展开更多
文摘目的 探讨冠心病合并2型糖尿病患者冠状动脉病变特征.方法 入选笔者医院2012年6月～ 2014年2月经冠状动脉造影诊断为冠心病的患者213例,根据是否合并2型糖尿病分为2型糖尿病组、非糖尿病组.统计患者入院基本临床资料,所有患者均检测空腹血糖（FPG）、总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）,根据冠状动脉狭窄直径≥50％累及左前降支（LAD）、左回旋支（LCX）、右冠状动脉（RCA）或左主干（LM）分为单支、双支（累及左主干为双支病变）及3支病变组.计量资料采用均数±标准差（x±s）表示,组间比较采用两独立样本t检验,计数资料采用率表示,组间比较用x2检验.结果 冠心病合并2型糖尿病组患者空腹血糖（FPG）比非糖尿病组明显升高（8.45±0.40mmol/L vs 5.61±0.13mmol/L,P＜0.001）,冠状动脉3支病变发生率更高（50.00％ vs 8.94％,P＜0.001）,单支病变、两支/左主干病变发生率低于非糖尿病组（24.4％ vs 48.8％,P＜0.001;25.6％ vs42.3％,P＜0.001）,冠状动脉病变部位更多累及前降支（92.2％ vs 82.1％,P=0.034）、左回旋支（68.9％ vs39.8％,P＜0.001）、右冠状动脉（64.4％ vs 39.0％,P＜0.001）,冠状动脉左主干病变并无统计学意义（7.8％ vs 2.4％,P=0.100）.结论 冠心病合并2型糖尿病患者冠状动脉病变更为广泛、严重,具有更高的致死风险.
文摘This is a review of the first 10 coronary artery bypass surgeries performed by the local team. The mean age was 62 years old [45 - 74]. The patients were predominantly male, with a M/F ratio of 4:1. Cardiovascular risk factors were mainly myocardial infarction (MI) (60%), hypertension (50%), obesity (40%) and diabetes (30%), with at least two risk factors per patient. Angina was the main symptom (80%). The average time from presentation to surgery was 8 months. The mean Euroscore 2 was 2.92 ± 1.65 [1.33 - 6.60]. Coronary angiography revealed an average of 2 lesions per patient, with 3-vessel involvement in 70% of cases: the Interventricular artery (IVA) (100%), the right coronary artery (90%) and the circumflex artery (70%). On echocardiography, the mean Left ventricular ejection fraction (LVEF) was 59% [33% - 76%]. All patients underwent median sternotomy with bypass grafting. The average duration of the cardiopulmonary bypass was 150 min [46 - 275 min];that of aortic clamping, 120 min [43 - 232 min]. The grafts used were internal thoracic artery (ITA) in 100% of cases (80% on the left and 20% on the right), and the great saphenous vein (GSV) in 60% of cases (50% on the left and 10 on the right). Double bypass was performed in 60% of cases, single bypass in 30% and triple bypass in 10%. The bypasses were performed on the IVA (100%), the middle lateral of the circumflex (30%) and the bisector (20%). The average time to extubation was 11 hours and the length of stay in the intensive care unit was 7 days [03 - 17 days]. One patient had a reoperation on Day 0 post-op. The average hospital stay was 13 days [06 - 27 days]. Complications occurred in nine of the patients (90%), with a predominance of infectious and neurological complications. Overall operative mortality was 3%, all in intensive care.
