2型糖尿病合并冠心病患者临床特点研究.docVIP

2型糖尿病合并冠心病患者的临床特点研究 　　【摘要】 目的 分析2型糖尿病患者并发冠心病的临床特点，为临床预防和治疗糖尿病并发冠心病提供依据。方法 选取2006年12月至2010年6月住院行冠状动脉造影术患者，其中2型糖尿病并发冠心病的病例46例，作为治疗组；2型糖尿病不合并冠心病病例30例为对照Ⅰ组；无糖尿病的冠心病患者50例为对照Ⅱ组。比较分析各组患者的一般情况、血糖、血压、血脂、糖化血红蛋白（HbA1C）和胰岛素敏感指数（ISI）；并把治疗组与对照Ⅱ组患者冠脉造影结果进行对比。结果 三组比较后发现，高血压、HbA1C、三酰甘油(TG)、低密度脂蛋白(LDLC)、ISI与糖尿病患者发生冠心病存在一些关系；糖尿病合并冠心病患者以3支病变多见。结论 2型糖尿病患者致动脉粥样硬化的因素多而复杂，临床中应针对上述因素加强综合观察与治疗。 　　【关键词】 2型糖尿病；冠心病；冠状动脉造影术?お? 　　 　　Clinical Characteristics of Type 2 Diabetes Mellitus with Coronary Heart Disease 　　 　　LIN Yu，FANG Yishan, XU Mingwei. Department ofEndocringology,People’s Hospital Jieyang，Guangdong,522000，China 　　 　　【Abstract】 Objective To investigate the characteristic of type 2 diabetes(T2DM)patients with coronary heart disease(CHD), and provide methods for prevention and treatment for patients who suffer from CHD. Methods The hospitalized patients from December 2006 to June 2010 were divided into three groups. The treatment group contents 46 examples who were T2DM with CHDM. The control groupⅠcontents 30 examples who were T2DM without CHDM. The control groupⅡcontents 50 examples who were CHD without T2DM. Compare their ordinary circumstances. The blood sugar, BP, TC, TG, HDL, LDL, HbA1C, CP, Ins were measured. Insulin sensitive index(ISI)was calculated. Results Three groups have obvious statistical difference in BP, TC, LDLC, ISI, HbA1C. Diabetic patients with coronary heart disease behave more common with three lesions. Conclusion In the clinical job should strengthen composite observation and treatment because the factors of atherosclerosis in T2DM patientsare numerous and complex. 　　【Key words】 Type 2 diabetic; Coronary heart disease; Coronary angiography 　　 　　 　　众所周知，冠心病是冠状动脉粥样硬化引起的多因素心脏病，其主要危险因素包括高龄、高脂血症、高血压、吸烟和糖尿病。糖尿病是一种全身代谢性疾病，其血管病变是引发其他复杂病变的基础，其中大血管病变常引起冠心病、脑血管病和周围血管病，其中冠心病是糖尿病大血管病变的主要危险因素之一。近几年来，冠心病心绞痛在我国的发病率及死亡率在逐年上升，同时糖尿病(DM)是一种严重危害人类健康的慢性病,继心血管病和肿瘤病后成为人类第三大非传染病，且二者之间互相影响，关系密切。文献报道糖尿病患者冠心病的发病率比非糖尿病患者高20多倍［1］；糖尿病患者50%～70%死于心血管系统并发症。本文对我院46例2型糖尿病患者经冠状动脉造影确定为冠