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目的通过血管内超声-虚拟组织学(IVUS-VH)技术探讨冠心病(CHD)合并糖尿病(DM)患者冠状动脉病变的特点及其与糖化血红蛋白(HbA1c)、糖化血清蛋白(GA)的相关性。方法对53例CHD合并DM患者及49例不合并DM的CHD患者冠状动脉进行IVUS-VH检查,分析两组斑块的性质及其与临床GA、HbA1c水平的相关性。结果 CHD合并DM患者易损斑块发生率显著高于不合并DM的CHD患者(36.7%∶14.5%,P<0.05),斑块组成以纤维脂肪组织和坏死成分为主,而不合并DM的CHD患者斑块纤维成分和钙化成分较高。GA水平与纤维脂肪组织呈正相关(r=0.018,P<0.05),明显优于HbA1c。结论 CHD合并DM患者易损斑块发生率明显高于不合并DM的CHD患者,且斑块成分不同。GA与冠状动脉粥样硬化斑块性质相关。
Objective To investigate the characteristics of coronary lesions and its relationship with HbA1c and GA in patients with coronary heart disease (CHD) and diabetes mellitus (DM) by intravascular ultrasound-virtual histology (IVUS-VH) . Methods The coronary arteries of 53 CHD patients with CHD and 49 CHD patients without DM were examined by IVUS-VH. The correlation between the two groups of plaque characteristics and the clinical levels of GA and HbA1c was analyzed. Results The incidence of vulnerable plaque in CHD patients with DM was significantly higher than that in non-DM CHD patients (36.7% vs 14.5%, P <0.05). The plaque composition was mainly composed of fibrotic tissue and necrosis without DM Patients with CHD plaque fibrosis and calcification composition is higher. The level of GA was positively correlated with fibrofatty tissue (r = 0.018, P <0.05), which was significantly better than that of HbA1c. Conclusions The incidence of vulnerable plaque in CHD patients with DM was significantly higher than that in CHD patients without DM, and the plaque components were different. GA is associated with coronary atherosclerotic plaque properties.