摘要
目的分析458例冠心病患者不同糖代谢状态的临床特征及其与冠状动脉病变特征的关系。方法选取458例经冠状动脉造影确诊的冠心病患者,按不同的血糖水平分为3组,即单纯冠心病组(A组)163例,冠心病合并糖调节受损组(B组)102例,冠心病合并糖尿病组(C组)193例,观察其临床特征、实验室指标及冠状动脉病变情况,探讨血糖及相关影响因素对冠心病的影响。结果 1各组间临床资料比较,B组及C组腰臀比值及糖尿病家族史显著高于A组(P<0.05),而在年龄、体质量指数、吸烟史、饮酒史、高血压史及冠心病家族史差异无统计学意义(P>0.05)。2各组间生化指标比较B组及C组空腹血糖、口服葡萄糖耐量试验(OGTT)2 h血糖、甘油三酯、高密度脂蛋白胆固醇及血尿酸显著高于A组(P<0.05),而在总胆固醇、低密度脂蛋白胆固醇及C反应蛋白差异无统计学意义(P>0.05)。3各组间冠脉照影资料比较,病变支数的比较B组及C组在双支及三支血管病变显著高于A组(P<0.05),病变程度的比较B组及C组在重度病变、闭塞病变及弥漫病变显著高于A组(P<0.05)。结论重视对于首次空腹血糖>5.6 mmol·L-1的非糖尿病患者进行OGTT,同时对于腹型肥胖及有糖尿病家族史的患者应重点干预。冠心病合并糖代谢异常在双支及多支病变发生率、闭塞病变及弥漫病变比例显著高于单纯冠心病组。
Objective To analyze the clinical feature and its relationship with pathological features of coronary in different pha- ses of carbohydrate metabolism in 458 cases with coronary heart disease. Methods 458 cases with coronary heart disease diagnosed by coronary arteriography were chosen, and they were divided into three groups according to blood glucose, including only coronary heart dis- ease （group A）, coronary heart disease complicated with impaired glucose regulation （group B） and coronary heart disease complicated with diabetes （ group C）. Their clinical features,laboratory indexes and pathological features of coronary were observed, so as to probe the impacts of blood glucose and other factors on coronary heart disease. Results The clinical data was compared among three groups. The waist to hip ratio and family history of diabetes in group B and group C was higher than that of group A （ P 〈 0.05 ）, and there were no notable statistics differences in terms of age, body mass index, smoking history, drinking history, high blood pressure history and family history of coronary （ P 〉 0.05 ）. The fasting blood - glucose, OGTI＇2h blood glucose, triglyceride, HDL - cholesterol and blood uric acid in group B and group C were much higher than those of group A （ P 〈 0.05 ）. However, there were no notable statistical differences in terms of total cholesterol,low density lipoprotein cholesterol and C - reactive protein （ P 〉 0.05 ）. There were much more double and triple ves- sels diseases in group B and group C than those in group A （P 〈0.05）. It was much more severe in group B and group C than that in group A in lesions, occlusion and diffuse lesion （ P 〈 0.05 ）. Conclusion It should pay more attention to the oral glucose tolerance test on non - diabetic patients whose first fasting blood - glucose is higher than 5.6 mmol · L^- 1, and at the same time, to adopt intervention in the patients of abdominal obesity and having family history of diabetes. The coronary heart disease complicated with abnormal glucose me- tabolism has higher incidence of pathological changes at double and triple vessels and higher rate of pathological changes to occlusion and diffuse lesion than those in the group of only coronary heart disease.
出处
《宁夏医学杂志》
CAS
2014年第11期1003-1006,共4页
Ningxia Medical Journal
基金
宁夏石嘴山市科技局重点立项项目(201328a)
关键词
冠心病
糖代谢
冠状动脉病变
Coronary heart disease
Different phases of carbohydrate metabolism
Coronary pathological features
