CAJ | 학술논문

目的探讨糖尿病前期空腹血糖受损与冠状动脉病变程度的相关性.方法同顾分析630例拟诊冠心病(CHD)并行冠状动脉造影患者的临床资料,冠脉造影病变程度以是否诊断CHD、冠脉病变支数和冠脉病变Gensini总积分三方面表示；根据空腹血糖(FPG)水平将所有研究对象分为3组:A组FPG＜ 5.6mmol/L者297例；B组5.6 mmol/L≤FPG＜6.1 mmol/L者185例；C组6.1 mmol/L≤FPG ＜7.0 mmol/L者148例.进行组间冠心病危险因素和冠脉病变程度比较,对FPG水平与冠脉病变程度进行单因素和多因素分析.结果 (1)A组冠心病患病率为32.7％,单支病变50.5％、双支病变30.9％,多支病变18.6％,Gensini积分13.26 ±3.15,B组冠心病患病率为40.5％,单支病变42.7％、双支病变32.0％,多支病变25.3％,Gensini积分24.53±4.26,C组冠心病患病率为57.4％,单支病变30.6％、双支病变32.9％,多支病变36.5％,Gensini积分30.45±4.03,三组比较,随着FPG逐渐升高,冠心病患病率、冠脉病变积分、多支病变发生率逐渐升高(P＜0.05)；(2)FPG与冠状动脉病变支数(r =0.413；P＜0.05)、冠脉病变Gensini积分(r=0.492;P＜0.05)呈正相关;(3)多元逐步回归分析显示FPG与冠脉病变支数(β=0.327,P＜0.05)、冠脉病变总积分(β=0.281,P＜0.05)独立相关；(4)Logistic回归分析显示FPG为冠心病独立危险因素(OR =3.042,95％CI:2.589 -6.275,P＜0.01).结论糖尿病前期空腹血糖受损与冠状动脉粥样硬化密切相关,随着FPG升高,冠状动脉病变程度严重.
목적 탐토당뇨병전기공복혈당수손여관상동맥병변정도적상관성.방법 동고분석630례의진관심병(CHD)병행관상동맥조영환자적림상자료,관맥조영병변정도이시부진단CHD、관맥병변지수화관맥병변Gensini총적분삼방면표시；근거공복혈당(FPG)수평장소유연구대상분위3조:A조FPG＜ 5.6mmol/L자297례；B조5.6 mmol/L≤FPG＜6.1 mmol/L자185례；C조6.1 mmol/L≤FPG ＜7.0 mmol/L자148례.진행조간관심병위험인소화관맥병변정도비교,대FPG수평여관맥병변정도진행단인소화다인소분석.결과 (1)A조관심병환병솔위32.7％,단지병변50.5％、쌍지병변30.9％,다지병변18.6％,Gensini적분13.26 ±3.15,B조관심병환병솔위40.5％,단지병변42.7％、쌍지병변32.0％,다지병변25.3％,Gensini적분24.53±4.26,C조관심병환병솔위57.4％,단지병변30.6％、쌍지병변32.9％,다지병변36.5％,Gensini적분30.45±4.03,삼조비교,수착FPG축점승고,관심병환병솔、관맥병변적분、다지병변발생솔축점승고(P＜0.05)；(2)FPG여관상동맥병변지수(r =0.413；P＜0.05)、관맥병변Gensini적분(r=0.492;P＜0.05)정정상관;(3)다원축보회귀분석현시FPG여관맥병변지수(β=0.327,P＜0.05)、관맥병변총적분(β=0.281,P＜0.05)독립상관；(4)Logistic회귀분석현시FPG위관심병독립위험인소(OR =3.042,95％CI:2.589 -6.275,P＜0.01).결론 당뇨병전기공복혈당수손여관상동맥죽양경화밀절상관,수착FPG승고,관상동맥병변정도엄중.
Objective To evaluate the correlation between impaired fasting glucose and the extent and severity of angiographic coronary artery disease( CAD ) in patients who underwent coronary angiography.Methods A total of 630 consecutivc patients who underwent coronary angiography were selected in the stndy.The extent and severity of angiographic CAD were diagnosed based on the followings:whether or not with CAD diagnosis by angiography,the number of diseased vessels,the CAD Gensini cumulative index.According to fasting plasma glucose ( FPG),all patients were divided into three group,group 1 ( FPG ＜5.6 mmol/L),group 2 ( 5.6 mmol/L ≤ FPC ＜ 6.1 mmol/L) and group 3 ( 6.1 mmol/L ≤ FPG ＜ 7.0mmol/L).The CHD risk factors and the lesion degree of coronary arteries were compared among three groups.The relation of FPG and CAD were analyzed by univariate and multivariate analyses.Results The incidence of CH and,the CAD Gensini cumulative index and the incidence of mult-vessel lesions were significantly different among the three subgroups ( all P ＜ 0.05 ).After adjusting other inffluencing factors,there were significantly positive correlation between the number of diseased vessels and the CAD Gensini cumulative index and FPG( P ＜0.05).The FPG had significant correlation with the diagnosis or not of CAD by angiography( OR =3.042,95％ CI:2.589 -6.275,P ＜0.01).Conclusions In prediabetic period,the extent and severity of angiographic coronary artery disease have significant correlations with the impaired fasting glucose,and the extent and severity can increase along with the increasing FPG.