2型糖尿病病程对拟诊冠心病患者的影响

摘要

Objective To investigate the impact of the duration of type 2 diabetes on coronary artery lesions.Methods A total of 131 patients with suspected coronary heart disease were divid-ed into three groups:patients without type 2 diabetes(control group,n=45),patients suffering from type 2 diabetes for less than 5 years(observation group 1,n = 40),and patients suffering from type 2 diabetes for 5 years or more(observation group 2,n=46).GE16-slice spiral CT was used for coronary artery imaging.Results Among the 131 patients,CTA showed coronary artery lesions in 86 and occlusion lesions in 18(199 calcified arteries and 150 involved coronary arteries). There was no significant difference in the number of involved coronary arteries between control group and observation group 1(P =0.328 4).Compared with observation group 2,the number of involved coronary arteries significantly decreased in control group and observation group 1(P <0.000 1).Compared with control group,calcified lesions significantly increased in observation group 1(P =0.009 1)and observation group 2(P <0.000 1).In addition,multivessel lesions and occlusion lesions increased with the extension of diabetes duration.Compared with observation group 2,multivessel lesions significantly decreased in control group(P =0.004 0)and observation group 1(P =0.017 6).Compared with control group,occlusion lesions significantly increased in observation group 1(P =0.016 1)and observation group 2(P =0.004 3).Conclusion The inci-dence of coronary heart disease and the severity of lesions of involved coronary arteries gradually increase with the extension of diabetes duration.CTA is helpful for the early diagnosis of coro-nary artery lesions.%目的：探讨2型糖尿病病程对冠脉病变的影响。方法选取临床拟诊冠心病患者131例，其中，以不合并2型糖尿病者为对照组（n＝45），以合并2型糖尿病患者（病程＜5年）为观察1组（n＝40），以合并2型糖尿病患者（病程≥5年）为观察2组（n＝46）。采用 GE16排螺旋 CT 对3组冠脉成像结果进行对照分析。结果131例患者中，CT 血管造影（CTA）共检出86例冠脉病变（含18例闭塞性病变），其中钙化病变199支、受累冠脉数150支。受累冠脉数：与对照组相比，观察1组差异无统计学意义（P ＝0．3284）；而 观察2组较其他2组明显增加（P ＜0．0001）。与对照组相比，糖尿病患者钙化病变多见（观察1组 P ＝0．0091；观察2组 P ＜0．0001）。随着糖尿病病程的延长，多支血管病变数增多（与观察2组比较：观察1组 P ＝0．0176；对照组 P ＝0．0040），闭塞性病变数也逐渐增多（与对照组比较：观察1组 P ＝0．0161；观察2组 P ＝0．0043）。结论随着糖尿病病程的延长，糖尿病患者合并冠心病的机会逐渐增加，受累的冠脉病变更严重，行冠脉 CTA 检查有利于早期明确诊断。