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目的 :探讨2型糖尿病合并严重冠状动脉粥样硬化性心脏病(冠心病)的危险因素。方法 :共入选320例2型糖尿病合并胸痛患者,根据冠状动脉(冠脉)造影结果分为单纯糖尿病组(n=80)和糖尿病合并冠心病组(n=240),分别检测其空腹血浆糖化血红蛋白(Hb A1c)、肌酐、血脂水平等各项生化指标,并采用主要冠脉病变支数(狭窄程度≥50%)及Gensini评分体系对其冠心病严重程度进行评估。结果 :校正传统危险因素后,多支病变(2支或3支病变)的独立危险因素包括年龄(OR=1.051)、体质量指数(BMI)(OR=0.905)、Hb A1c(OR=1.343)和血肌酐(OR=1.023)(P均<0.05)。高Gensini评分组(>32分)的独立危险因素为高密度脂蛋白胆固醇(HDL-C)(OR=0.169,P<0.01),其中年龄、BMI、Hb A1c、血肌酐水平与病变支数呈正相关(P均<0.05),而Hb A1c与Gensini评分呈正相关(P<0.01),HDL-C则与Gensini评分呈负相关(P<0.05)。结论 :年龄、BMI、Hb A1c、血肌酐及HDL-C是2型糖尿病患者合并严重冠脉病变的独立危险因素。
Objective: To explore the risk factors of type 2 diabetes mellitus with severe coronary atherosclerotic heart disease (CHD). Methods: A total of 320 patients with type 2 diabetes mellitus complicated with chest pain were enrolled and divided into simple diabetic group (n = 80) and diabetic patients with coronary heart disease (n = 240) according to coronary artery angiography (coronary angiography) Hb A1c, creatinine, blood lipid level and other biochemical parameters. The severity of coronary heart disease was evaluated by the main coronary lesion count (≥50%) and Gensini scoring system. Results: The independent risk factors of multiple lesions (2 or 3 lesions) after correction of traditional risk factors included age (OR = 1.051), BMI (OR = 0.905), Hb A1c (OR = 1.343) And serum creatinine (OR = 1.023) (all P <0.05). The independent risk factor for high Gensini score (> 32 points) was HDL-C (OR = 0.169, P <0.01). The age, BMI, Hb A1c, (P <0.05), while Hb A1c was positively correlated with Gensini score (P <0.01). HDL-C was negatively correlated with Gensini score (P <0.05). Conclusion: Age, BMI, Hb A1c, serum creatinine and HDL-C are independent risk factors for type 2 diabetes with severe coronary artery disease.