老年冠心病合并糖耐量减低患者不同血糖水平与冠状动脉病变的研究

摘要

Objective To study the correlation between different blood glucose levels and coronary artery lesion in elderly CHD patients with impaired glucose tolerance. Methods Two hundred and twelve patients with angiography confirmed CHD, included in this study, were divided into nor mal glucose tolerance(NGT) group(n = 64) and impaired glucose tolerance(IGT) group(n=148) according to oral glucose tolerance test. Patients in IGT group were further divided into IGT1 group(n = 50),IGT2 group(n = 58) and IGT3 group(n = 40) according to their postprandial 2 h blood glucose levels. Coronary lesions,diffuse coronary lesions and total coronary artery Gensini cumulative score were compared in different groups. Results The LDL-C level,incidence of dif fuse coronary lesions and total coronary artery Gensini cumulative score were significantly higher in IGT1 ,IGT2 and IGT3 groups than in NGT group(P<0. 05). The incidence of double coronary lesions was significantly higher in IGT1 and IGT3 groups and significantly lower in IGT2 group than in NGT group(P<0. 05). The total coronary artery Gensini cumulative score was positively correlated with the postprandial 2 h blood glucose level(r=0. 512, P<0. 05). Conclusion Im paired glucose tolerance can exacerbate coronary artery lesions. Patients with an elevated post prandial 2 h blood glucose level are the high risk population of atherosclerosis and should thus be treated as early as possible.%目的 探讨老年冠心病合并糖耐量减低患者不同血糖水平与冠状动脉病变的相关性.方法 回顾分析经冠状动脉造影确诊冠心病的老年患者212例临床资料,根据口服葡萄糖耐量试验结果分为糖耐量正常(NGT)组64例,糖耐量减低(IGT)患者148例,又根据餐后2h血糖水平分为IGT1组50例,IGT2组58例和IGT3组40例,比较各组的冠状动脉病变支数、弥漫性病变状况以及冠状动脉病变Gensini总积分.结果 与NGT组比较,IGT1组、IGT2组、IGT3组LDL-C水平、弥漫性病变比例、Gensini积分明显升高(P＜0.05)；IGT1组、IGT3组双支病变比例明显升高,IGT2组双支病变比例明显下降(P＜0.05).冠状动脉Gensini积分与餐后2h血糖呈正相关(r=0.512,P＜0.05).结论 IGT加重了冠状动脉病变程度.餐后2h血糖升高的患者是动脉粥样硬化的高危人群,对于此类人群应及时早期干预、治疗.