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目的探讨冠心病合并2型糖尿病患者的临床表现及冠状动脉病变特点。方法将入选的480例冠心病患者分为糖尿病组(DM组)和非糖尿病组(NDM组),统计分析2组患者的危险因素、临床表现、并发症及冠状动脉病变特点。结果(1)危险因素比较:2组患者性别、高血压病史、TC、LDL-C、阳性家族史等比较差异无统计学意义(P>0.05),DM组肥胖患者比例及TG水平均高于NDM组,吸烟患者少于NDM组(P<0.05)。(2)临床表现比较:2组患者典型胸痛症状比例差异无统计学意义(P>0.05),DM组患者心肌梗死、心律失常、心力衰竭及心源性休克等并发症均多于NDM组(P<0.05)。(3)冠状动脉造影结果:2组患者LAD、LCX、RCA分布方面比较差异无统计学意义(P>0.05),DM组患者LM、三支及弥漫性血管病变方面多于NDM组(P<0.05)。(4)2组冠状动脉狭窄程度积分比较,1分、2分比例差异无统计学意义(P>0.05),3分、4分、5分比例差异显著(P<0.05)。结论冠心病合并糖尿病患者心肌梗死发病率高,临床并发症多,冠状动脉病变弥漫且狭窄程度严重,累及左主干较多。临床积极早期干预血糖有利于冠心病的防治。
Objective To investigate the clinical manifestations and coronary artery lesions in patients with coronary heart disease complicated with type 2 diabetes mellitus. Methods The selected 480 patients with coronary heart disease were divided into diabetic group (DM group) and non-diabetic group (NDM group). The risk factors, clinical manifestations, complications and the characteristics of coronary artery lesions in two groups were statistically analyzed. Results (1) Comparison of risk factors: There was no significant difference in gender, history of hypertension, TC, LDL-C, positive family history between the two groups (P> 0.05) NDM group, smoking patients less than NDM group (P <0.05). (2) Comparison of clinical manifestations: There was no significant difference in the proportion of typical chest pain between the two groups (P> 0.05). Complications of myocardial infarction, arrhythmia, heart failure and cardiogenic shock in DM group were more than those in NDM group P <0.05). (3) Results of coronary angiography: The distribution of LAD, LCX and RCA in two groups had no significant difference (P> 0.05). There were more LM, three branches and diffuse vascular lesions in DM group than in NDM group (P < 0.05). (4) There was no significant difference between the two groups in the score of coronary artery stenosis (P> 0.05), and there was significant difference in the score of 3, 4 and 5 (P <0.05). Conclusion The incidence of myocardial infarction in patients with coronary heart disease complicated with diabetes mellitus is high, and there are many clinical complications. The prevalence of coronary artery disease is diffuse and the stenosis is serious, involving the left main trunk more. Clinical positive early intervention blood glucose is conducive to the prevention and treatment of coronary heart disease.