血管内超声对合并糖耐量减低的冠心病患者临界病变的临床研究

摘要

Objective To evaluate the influence of impaired glucose tolerance on coronary artery lesions in patients with coronary heart disease by using intravascular ultrasound. Methods Eighty- nine patients with coronary heart disease were divided into diabetes group (group A),impaired glucose tolerance group (group B), and normal glucose tolerance group (group C). All patients were checked by coronary angiography (CAG), and had at least one major coronary artery stenosis with a degree ranging from 40 % to 70 % . External elastic membrane cross - sectional area (EEMA),plaques area (PA) , minimal lumen area (MLA) and plaque burden (PB) were measured by IVUS. Results Incidence rate of hypertension and hyper lipidemia was higher in groups A and B than in group C. There was no significant difference between group A and group B. Group A and group B had increased in EEM, PA, PB, Soft plaques and thrombosis. Conclusion Patients of intermediate coronary stenosis with impaired glucose tolerance have more serious coronary artery disease.%目的 对于冠脉造影提示临界病变的患者,通过血管内超声检查,了解冠心病合并糖耐量减低的冠脉病变斑块情况,探讨糖耐量减低对冠状动脉病变的影响.方法 89例临床诊断为冠心病的患者,分为合并2型糖尿病(T2DM)组(A组)、糖耐量减低(IGT)组(B组)、糖代谢正常组(NDM)(C组),所有患者均进行冠状动脉造影检查,明确至少有一支主要冠状动脉狭窄程度在40％～70％,所有患者均行血管内超声检查,测量临界病变处血管外弹力膜面积(EEMA)、斑块面积(PA)、最小管腔面积(MLA)、斑块负荷(PB),并分析斑块性质.结果 A组与B组合并高血压及高血脂的发生率较C组高,A组与B组间无显著差别;A组与B组MLA明显＜C组,而EEM、PA和PB明显＞C组.A组与B组软斑块及血栓形成病例均较C组多见.结论 在冠脉造影提示临界冠脉病变的冠心病患者中,合并糖耐量减低患者与合并糖尿病患者一样,冠脉病变均较严重,且斑块不稳定,故对合并糖耐量减低的冠心病患者应及早干预,积极控制血糖.