【摘要】 目的探讨冠心病患者血糖水平与冠状动脉病变Gensini评分的相关性。方法入选经冠状动脉造影确诊冠心病,并排除糖尿病的患者328例,行口服葡萄糖耐量(OGTT)试验,根据OGTT试验结果,将患者分为5组,血糖正常组、单纯空腹血糖受损(IFG)组、单纯糖耐量受损(IGT)组、复合糖耐量受损组、新诊断糖尿病组,通过Gensini评分系统对其冠状动脉病变程度进行评分,进行组间冠心病危险因素和冠状动脉病变程度比较,同时对FPG、2 h PG水平与冠状动脉病变Gensini进行单因素和多因素分析。结果单纯空腹血糖受损组、单纯糖耐量受损组、复合糖耐量受损组及新诊断糖尿病组的冠状动脉病变总积分均高于血糖正常组(P均<0.05);尤以IGT组、复合糖耐量受损组、新诊断糖尿病组增高显著;空腹血糖受损、糖耐量受损、复合糖耐量受损组、新诊断糖尿病组的组间冠状动脉病变总积分无显著差异(P均>0.05)。2 h PG与冠状动脉病变Gensini积分(r=0.358;P<0.001)呈正相关,FPG与冠状动脉病变Gensini积分(r=0.232;P=0.046)呈正相关。多元逐步回归分析显示2 h PG与冠状动脉病变总积分(β=0.358,P=0.000)独立相关。结论 IGT、IFG、新发糖尿病与冠状动脉粥样硬化密切相关,加重冠状动脉病变程度,尤其以餐后血糖升高对冠状动脉病变的影响显著。更多还原

【Abstract】 Objective To investigate the association between blood glucose levels and Gensini score in patients with coronary artery disease(CAD). Methods A total of 328 CAD patients confirmed by coronary angiography and without known diabetes were selected in the study.The coronary arterial lesion of angiopraphic CAD were diagnosed by the CAD Gensini cumulative index. According to fasting plasma glucose(FPG) and 2 h plasma glucose(2 h PG) after glucose tolerance test(OGTT), all patients were stratified into five groups:Group 1: Normal glucose tolerance, FPG<5.6 mmol/L and 2 h PG<7.8 mmol/L; Group 2: Impaired fasting glucose(IFG), 5.6 mmol/L≤FPG<7.0 mmol/L and 2 h PG<7.8 mmol/L;Group 3: Impaired glucose tolerance(IGT), FPG< 5.6 mmol/L and 7.8 mmol/L≤2 h PG<11.1 mmol/L; Group 4:Both IFG and IGT, 5.6 mmol/L≤FPG< 7.0 mmol/L and 7.8 mmol/L≤2 h PG<11.1 mmol/L; Group 5: Newly diagnosed diabetes, FPG≥7.0 mmol/L or 2 h PG≥11.1 mmol/L.The CAD risk factors and the lesion degree of coronary arteries were compared among five groups.The relation of FPG, 2 h PG and CAD Gensini score were analyzed by univariate and multivariate analyses.Results Compared with group 1, the CAD Gensini score were significantly higher in the other four groups(all P<0.05),but there were no significantly difference between the other four groups(all P>0.05). After adjusting other influencing factors, there was significantly positive correlation between the CAD Gensini score and 2 h PG(P<0.05). Conclusions The lesion and severity of angiographic coronary artery disease have significant correlation with the impaired glucose tolerance, impaired fasting glucose, and newly diagnosed diabetes, and 2 h PG was significantly associated with an increase in the coronary artery Gensini score.更多还原