| 1.Objective:Toretrospectively study the characteristics of coronary artery lesions,cardiac function changes,and clinical characteristics of patients with type 2 diabetes and coronary heart disease,to understand their risk factors and mechanism,so as to further determine the importance of diabetes,monitor and control good blood sugar,and are Prevention and prognosis lay the cornerstone,provide clinical diagnosis and treatment ideas and provide a basis for improving patient prognosis.2.Methods:A total of 608 patients who visited Qinghai Provincial Cardiovascular and Cerebrovascular Hospital from January 2018 to October 2019 were retrospectively included,including T2 DM + CHD group(n = 369)and CHD group(n = 239).Patients with T2 DM + CHD were divided into two groups according to Hb A1 c level: Hb A1 c ≤ 7% Hb A1c> 7% group.Patients with T2 DM + CHD were then divided into three groups according to the duration of diabetes: Y < 5 years group,5 years ≤ Y ≤ 10 years group,and Y > 10 years group.For the general data,biochemical indicators,coronary angiography and echocardiography data of each sample,SSPS 23.0 statistical software was used to analyze the results.3.Results:3.1 comparison of clinical data between the diabetic group with coronary heart disease and the simple coronary heart disease group.(1)There were significant differences in smoking history,drinking history,ethnicity and detection rate of hypertension between the two groups(p< 0.05).The CHD group was mainly male,and had a higher proportion of smoking history,drinking history,and Han nationality than the T2 DM + CHD group.However,in the detection rate of hypertension,the T2 DM + CHD group was higher than the CHD group.(2)there were statistical differences in FPG,Hb A1 c,TG,HDLand HBG between the two groups(p< 0.05).FPG,Hb A1 c and TG in T2 DM + CHD group were higher than that in CHD group,while HDL,HCT and HBG in T2 DM + CHD group were lower than that in CHD group.(3)therewere statistical differences in the number ofcoronary artery involvement,the degree of coronary artery stenosis,and the distribution of affected vessels between the two groups(p< 0.05).In the CHD group,single-vessel lesions were involved,and vascular stenosis was mainly moderate and severe.In the T2 DM + CHD group,multi-vessel lesions were involved,and vascular stenosis was mainly severe and occluded.In the T2 DM + CHD group,LAD,RCA and LM were mainly involved,and LCX was less involved.In the CHD group,LAD,RCA and LCX were mainly involved,and LM was less involved.LCX slightly less than CHD group.(4)there were statistical differences in LAS,LVEF and FS between the two groups(p< 0.05).LAS in T2 DM + CHD group was higher than that in CHD group.LVEF and FS of T2 DM + CHD group were lower than that of CHD group.3.2 comparison of the course and clinical data of Hb A1 c and diabetes in patients with coronary heart disease3.2.1 comparison of Hb A1 c and clinical data in the diabetic group with coronary heart disease(1)There were significant differences in FPG,Hb A1 c,TG,TC,HDL,BUN,between the two groups(p< 0.05).FPG,TG,TC,BUN were higher in the Hb A1 c > 7% group than in the Hb A1c≤7% group;HDL was lower in the Hb A1c> 7% group than in the Hb A1c≤7% group.(2)There were significant differences in the number of involved coronary arteries and the degree of coronary artery stenosis between the two groups(p< 0.05).In the Hb A1 c > 7% group,multivessel involvement,vascular stenosis was severe,and occlusion was predominant.(3)There were significant differences in LVD,LVEF and FS between the two groups(p< 0.05).LVD was higher in the Hb A1 c > 7% group than in the Hb A1 c ≤ 7% group;LVEF and FS were lower in the Hb A1 c > 7% group than in the Hb A1c≤7% group.3.2.2 comparison of diabetes course and clinical data in the group of diabetes mellitus complicated with coronary heart disease(1)There were statistical differences in FPG,Hb A1 c,TC,and HDL among the three groups(p< 0.05).With the extension of the duration of diabetes,Hb A1 c,FPG,and TC gradually increased,and HDL gradually decreased.(2)There were significant differences in the number of involved coronary arteries,the degree of coronary stenosis,and the distribution of involved vessels among the three groups(p< 0.05).There was an association between the duration of diabetes and the degree of coronary stenosis(Gamma coefficient 0.368,p< 0.001),that is,the degree of vascular stenosis gradually increased with the duration of diabetes.There was an association between the duration of diabetes and the number of coronary arteries involved(Gamma coefficient 0.394,p< 0.001),that is,the number of vessels involved gradually increased with the duration of the disease.LAD vascular involvement was predominant in the Y < 5 years group and the 5 years ≤Y≤10 years group,and RCA vascular involvement was predominant in the Y > 10 years group.(3)There were significant differences in LVSD and LVEF among the three groups(p< 0.05).LVSD was higher in the Y > 10 years group than in the Y < 5 years group.With the prolongation of the course of diabetes mellitus,LVEF decreased gradually.4.Conclusion:(1)Diabetic patients with coronary heart disease have more severe coronary artery disease than patients with coronary heart disease alone,mainly three-vessel disease,and severe and occluded vascular stenosis is rare.(2)In patients with diabetes and coronary heart disease,with the extension of the course of diabetes and the increase of Hb A1 c levels,the cardiac contractile function gradually declines.(3)Hb A1 c and duration of diabetes were risk factors affecting the severity of coronary artery disease and cardiac function. |
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