| Background:Along with improvement of living standards and changes in diet,the incidence of coronary heart disease (CHD) and type 2 diabetes mellitus(T2DM) increased year by year, T2DM patients complicated with CHD or CHD patients complicated with T2DM and other metabolic diseases have increased more. We found that in clinical work, the count of coronary artery lesions of CHD patients complicated with T2DM were relatively more involved, and the lesions were more serious. To further study the impact of metabolic disorder caused by CHD combined T2DM on the lesions of coronary artery, we explore the characteristics of coronary angiography of CHD patients complicated with T2DM.Objective:To explore and analyze the angiographic characteristics of CHD patients complicated with T2DM by using some related risk factors, in order to get the pathogenesis on the lesions of coronary artery.Subjects and methods:The 355 patients who were in the cardiology of our hospital within a period of time,had detailed record and diagnosis of CHD by coronary angiography, were divided into T2DM group (122 cases) and non-diabetic (NDM) group (243 cases).Then we collated and added up the general clinical data of them, and CHD, T2DM, hypertension and angina were in accordance with unified and anthoritatively standards. The selective left and right coronary angiography according to standard Judkins method,and the counts of coronary artery lesions and the involved situation of the left anterior descending, left circumflex, left main and right coronary lesions were statistical counted. The coronary stenosis greater than or equal to 50% by two orthogonal projection position angiography at least,the diagnosis of coronary stenosis was established. Diffuse lesions consistent with any of the following one can be:①length of lesion≥2cm;②multiple lesions of one count;③whole or most of the vessels were thin and stiff or were significantly tortuous thin loose spring-like. The result were got from a relevant professional physician's blinded independent film-reading. Taking into account the course of disease,we statistical analyzed the choices on treatment from two groups of patients, including percutaneous transluminal coronary intervention(PCI), coronary artery bypass graft surgery(CABG) and drug conservative therapy.Results:1.On clinical information, T2DM group body mass index(BMI) (25.58±2.96) kg/m2,history of hypertension 73 cases (65.2%), painless history of angina pectoris 38 cases (33.9%),triglycerides(TG)(2.11±0.89)mmol/L,uric acid (UA)(352±95.86)mmol/L,higher than the NDM group BMI (24.71±2.77)kg/m2, history of hypertension 93 cases (38.3%),painless history of angina pectoris 42 cases (17.3%),TG(1.38±1.01)mmol/L,UA(301±89.41)mmol/L(P<0.05), T2DM group LVEF(58.82±6.47%)lower than the NDM group LVEF (62.41±4.84)%(P<0.05).2.In terms of coronary lesions, T2DM group of three-vessel lesions occurred (29.5%), left main lesions (11.6%) and diffuse lesions (39.3%) higher than the probability of NDM group(18.9%),(3.3%)and(21.4%), while the occurrence of single-vessel lesions (21.4%) is less than NDM group (34.2%)(P<0.05).3.In the treatment of choice, T2DM group selected CABG (42.0%) or drug conservative therapy (6.2%) higher than the probability of NDM group (30.1%) and (1.2%), and selected PCI (51.8%) less than the probability of NDM group (68.7%) (P<0.05).Conclusions:CHD patients complicated withT2DM often have multiple risk factors such as hypertension, hyperlipidemia, insulin resistance and hyperinsulinemia,etc. The interaction of these factors result in complicated and serious coronary lesions. |
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