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目的探讨2型糖尿病合并冠心病患者冠状动脉病变的特点及尿白蛋白与冠状动脉病变程度的关系。方法随机选取经冠状动脉造影确诊的冠心病患者,其中2型糖尿病合并冠心病患者64例为A组,单纯冠心病患者98例为B组,比较两组患者的临床资料和冠状动脉病变情况。A组患者根据冠脉病变支数分为3个亚组,即1支、2支、3支病变组,比较亚组间的尿白蛋白水平;A组患者以年龄、体质量指数、糖尿病病程、血压、血糖、糖化血红蛋白、血脂、尿白蛋白为自变量,分别以病变数、冠脉狭窄指数为因变量进行多元逐步回归分析。结果A组与B组患者在体质量指数、血糖、甘油三酯、高密度脂蛋白胆固醇、尿白蛋白方面的差异均有统计学意义(P均<0.05);与B组患者比较,A组患者冠脉多支病变发生率、弥漫性病变发生率、病变数、冠脉狭窄指数均较高(P均<0.05);A组各亚组间尿白蛋白的差异有统计学意义(P<0.05),病变数、冠脉狭窄指数与尿白蛋白均呈正相关(r值分别为0.5384、0.5762,P均<0.05)。结论2型糖尿病合并冠心病患者冠状动脉病变累及范围广,病变弥漫且严重;尿白蛋白排泄量增加是2型糖尿病发生冠心病的一个危险因素,可在一定程度上反映冠状动脉病变的程度。
Objective To investigate the characteristics of coronary lesions in patients with type 2 diabetes mellitus complicated with coronary heart disease and the relationship between urinary albumin and the degree of coronary artery lesion. Methods A total of 64 coronary heart disease patients with type 2 diabetes mellitus were selected as group A, and 98 patients with simple coronary heart disease were selected as group B. The clinical data and coronary artery lesions of two groups were compared. Patients in group A were divided into 3 subgroups according to the number of coronary lesions, namely 1, 2, 3 lesions group, and the urinary albumin level was compared between subgroups. The patients in group A were divided into three groups according to age, body mass index, duration of diabetes , Blood pressure, blood glucose, glycosylated hemoglobin, blood lipids, urinary albumin as independent variables, respectively, the number of lesions, coronary stenosis index as the dependent variable multiple stepwise regression analysis. Results The differences of body mass index, blood glucose, triglyceride, high density lipoprotein cholesterol and urinary albumin in group A and group B were statistically significant (all P <0.05). Compared with group B, group A Patients with coronary artery disease, diffuse lesions, lesions, coronary stenosis index were higher (P all <0.05); A subgroup urine albumin difference was statistically significant (P < 0.05). The number of lesions and coronary artery stenosis index were positively correlated with urinary albumin (r = 0.5384 and 0.5762, respectively, P <0.05). Conclusions Patients with type 2 diabetes mellitus and coronary heart disease have a wide range of coronary lesions and diffuse and severe lesions. Increased urinary albumin excretion is a risk factor for coronary heart disease in type 2 diabetes mellitus, which can reflect the degree of coronary artery lesion to some extent.