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目的:探讨糖耐量受损与冠状动脉(冠脉)病变程度的相关性。方法:回顾分析524例拟诊冠心病(CHD)并行冠脉造影患者的临床资料,冠脉造影病变程度以诊断是否CHD、冠脉病变支数和冠脉病变Gensini总积分三方面确定;根据口服葡萄糖耐量试验2 h血浆葡萄糖(2 h PG)水平将所有研究对象分为3组:第1组,2 h PG<7.8 mmol/L;第2组,2 h PG 7.8～11.0 mmol/L;第3组,2 h PG≥11.1 mmol/L。进行组间CHD危险因素和冠脉病变程度比较,对2 h PG水平与冠脉病变程度进行单因素和多因素分析。结果:①随着2 h PG逐渐升高,CHD患病率、冠脉病变积分、多支病变发生率逐渐升高(P<0.05);②2 h PG水平与冠脉病变支数(r=0.346;P<0.05)、冠脉病变Gensini积分(r=0.418;P<0.05)呈正相关;③多元逐步回归分析显示2 h PG水平与冠脉病变支数(β=0.383,P<0.05)、冠脉病变总积分(β=0.304,P<0.05)独立相关;④Logistic回归分析显示2 h PG水平为CHD独立危险因素(OR:2.685;95%CI:1.257～2.869;P<0.01)。结论:糖耐量受损与冠脉粥样硬化密切相关,随着2 h PG水平升高,冠脉病变程度愈严重。
Objective: To investigate the relationship between impaired glucose tolerance and severity of coronary artery (coronary artery) disease. Methods: The clinical data of 524 CHD patients undergoing coronary angiography were retrospectively analyzed. The extent of coronary angiography was diagnosed by CHD, the number of coronary lesions and the total Gensini score of coronary lesions. According to the oral Glucose tolerance test 2 h plasma glucose (2 h PG) levels All subjects were divided into three groups: group 1, 2 h PG <7.8 mmol / L; group 2, 2 h PG 7.8 ~ 11.0 mmol / L; 3 groups, 2 h PG≥11.1 mmol / L. The CHD risk factors and the degree of coronary artery disease were compared among groups. Univariate and multivariate analysis were performed on the level of PG in 2 h and the severity of coronary artery disease. Results: (1) The prevalence of CHD, coronary artery disease score and multivessel disease increased gradually with the increase of 2 h PG (P <0.05); ② The correlation between 2 h PG level and the number of coronary lesions (r = 0.346 ; P <0.05); Coronary artery disease Gensini score (r = 0.418; P <0.05) was positively correlated; ③Multivariate stepwise regression analysis showed that the level of PG in 2 h and the number of coronary lesions (β = 0.383, Logistic regression analysis showed that 2-hour PG level was an independent risk factor for CHD (OR: 2.685; 95% CI: 1.257-2.869; P <0.01). Conclusion: Impaired glucose tolerance is closely related to coronary atherosclerosis. With the increase of 2 h PG level, the severity of coronary artery disease is more serious.