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目的探讨不同糖代谢状态下老年冠心病(CAD)患者冠状动脉病变的范围及严重程度。方法比较不同糖代谢状态组在临床生化指标、狭窄冠状动脉支数、冠状动脉狭窄严重程度积分等方面的差别。结果 IGR组和DM组的高敏C反应蛋白(hsC-RP)和胰岛素抵抗指数(HOMA-IR)均高于糖代谢正常(NGT)组(P<0.05)。狭窄冠状动脉支数、Gensini积分与hsC-RP、HOMA-IR均呈正相关(P均<0.05)。IGR组及DM组受累冠状动脉支数明显多于NGT组(P<0.01),Gensini积分亦明显高于NGT组(P<0.01)。DM组复杂病变的发生率明显高于NGT组(P=0.004),其3支病变的发生率亦均高于NGT组及IGR组(P<0.05)。结论 IGR及糖尿病均可加重老年CAD患者冠状动脉病变的范围及严重程度。
Objective To investigate the extent and severity of coronary lesions in elderly patients with coronary artery disease (CAD) under different glucose metabolism status. Methods The differences of clinical biochemical parameters, stenosis coronary artery stenosis and severity of coronary artery stenosis were compared among different glycometabolism groups. Results The levels of hsC-RP and HOMA-IR in IGR group and DM group were significantly higher than those in normal glucose metabolism group (P <0.05). Stenosis coronary artery count, Gensini score and hsC-RP, HOMA-IR were positively correlated (P all <0.05). The number of coronary artery involvement in IGR group and DM group was significantly higher than that in NGT group (P <0.01), Gensini score was also significantly higher than NGT group (P <0.01). The incidence of complex lesions in DM group was significantly higher than that in NGT group (P = 0.004), and the incidence of 3 lesions was also higher than that in NGT group and IGR group (P <0.05). Conclusion Both IGR and diabetes may aggravate the extent and severity of coronary lesions in CAD patients.