CAJ | 학술논문

目的：探讨冠心病合并2型糖尿病患者的临床表现及冠状动脉病变特点。方法将入选的480例冠心病患者分为糖尿病组（ DM组）和非糖尿病组（ NDM组），统计分析2组患者的危险因素、临床表现、并发症及冠状动脉病变特点。结果（1）危险因素比较：2组患者性别、高血压病史、TC、LDL-C、阳性家族史等比较差异无统计学意义（ P ＞0 n．05），DM组肥胖患者比例及TG水平均高于NDM组，吸烟患者少于NDM组（ P ＜0．05）。（2）临床表现比较：2组患者典型胸痛症状比例差异无统计学意义（ P ＞0．05），DM组患者心肌梗死、心律失常、心力衰竭及心源性休克等并发症均多于NDM组（ P ＜0．05）。（3）冠状动脉造影结果：2组患者LAD、LCX、RCA分布方面比较差异无统计学意义（ P ＞0．05），DM组患者LM、三支及弥漫性血管病变方面多于NDM组（ P ＜0．05）。（4）2组冠状动脉狭窄程度积分比较，1分、2分比例差异无统计学意义（ P ＞0．05），3分、4分、5分比例差异显著（ P ＜0．05）。结论冠心病合并糖尿病患者心肌梗死发病率高，临床并发症多，冠状动脉病变弥漫且狭窄程度严重，累及左主干较多。临床积极早期干预血糖有利于冠心病的防治。
목적：탐토관심병합병2형당뇨병환자적림상표현급관상동맥병변특점。방법장입선적480례관심병환자분위당뇨병조（ DM조）화비당뇨병조（ NDM조），통계분석2조환자적위험인소、림상표현、병발증급관상동맥병변특점。결과（1）위험인소비교：2조환자성별、고혈압병사、TC、LDL-C、양성가족사등비교차이무통계학의의（ P ＞0 n．05），DM조비반환자비례급TG수평균고우NDM조，흡연환자소우NDM조（ P ＜0．05）。（2）림상표현비교：2조환자전형흉통증상비례차이무통계학의의（ P ＞0．05），DM조환자심기경사、심률실상、심력쇠갈급심원성휴극등병발증균다우NDM조（ P ＜0．05）。（3）관상동맥조영결과：2조환자LAD、LCX、RCA분포방면비교차이무통계학의의（ P ＞0．05），DM조환자LM、삼지급미만성혈관병변방면다우NDM조（ P ＜0．05）。（4）2조관상동맥협착정도적분비교，1분、2분비례차이무통계학의의（ P ＞0．05），3분、4분、5분비례차이현저（ P ＜0．05）。결론관심병합병당뇨병환자심기경사발병솔고，림상병발증다，관상동맥병변미만차협착정도엄중，루급좌주간교다。림상적겁조기간예혈당유리우관심병적방치。
Objective To investigate the clinical manifestations and coronary artery lesions in patients with coronary heart disease and type 2 diabetes.Methods The enrolled 480 coronary heart disease patients were divided into diabetic group (DM) and non-diabetic group (NDM group), statistical analysis of risk factors for the two groups of patients , clinical mani-festations, complications and angiographic characteristics .Results (1) Comparison of risk factors:Gender differences in the two groups of patients , hypertension ,serum levels of TC , LDL-C, positive family history , etc.was not statistically significant ( P >0.05),DM group obesity proportion,serum TG level were more common than NDM group , smoking patients were more common than NDM group ( P <0.05).(2) Clinical manifestations comparison:the proportion of patients with atypical chest pain differences between the two groups of patients was not statistically significant ( P >0.05), myocardial infarction patients in DM group, arrhythmia, heart failure and cardiogenic shock and other complications were more common than NDM group (P <0.05).(3) Coronary angiography: aspects of LAD, LCX, RCA distribution difference between the two groups were not statistically significant ( P >0.05), DM patients LM, three vascular disease and diffuse lesions were more common than NDM group ( P <0.05).(4) The degree of coronary stenosis in the two groups , 2 points compared to 1 point, 2 points difference was not statistically significant proportion ( P >0.05), 3 points, 4 points, 5 points differences were significant (P <0.05).Conclusion Myocardial infarction in diabetic patients with coronary heart disease incidence , clinical complica-tions, diffuse coronary artery disease and severe stenosis more likely to involve the left main .Clinical early intervention of con-trol blood sugar is good for coronary heart disease prevention .