冠状动脉疾病中糖尿病患者与非糖尿病患者的冠状动脉造影结果:比较研究

Syed Mahabub Ebna Al Baker, Mohammad Nizamul Hossain Showdagor, Mukhlesur Rahman, Manzoor Mahmood, Ahsan Habib, Fazlur Rahman, Syed Ali Ahsan
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摘要

背景与目标:冠状动脉疾病(CAD)是糖尿病患者死亡的主要风险因素。冠状动脉造影术是诊断和评估 CAD 的 "金标准 "技术。材料和方法:本研究于 2017 年 11 月至 2021 年 12 月期间在达卡边防医院进行。对 204 名提示缺血性胸痛的连续患者进行了经皮冠状动脉造影术(CAG)。其中 88 例为糖尿病患者,116 例为非糖尿病患者:我们观察到两组患者的血管病变情况,比较了受累血管的部位和数量,以及血管狭窄的平均百分比。两组患者的冠状动脉危险因素无明显差异。两组的血管造影阳性病变总数均为(61.5%)。在糖尿病患者中,CAG 阳性率为 69.3%。公认的病变为单血管疾病(SVD)23 例(26.1%)、双血管疾病(DVD)14 例(15.9%)、三血管疾病(TVD)24 例(27.3%),血管狭窄率为 82.63%。另一方面,非糖尿病组血管造影阳性病变总数为 70(53.4%),其中单血管病变(SVD)30(25.9%),双血管病变(DVD)15(12.9%),三血管病变(TVD)17(14.7%)。未发现弥漫性病变,血管平均狭窄率为 78.03%。血管造影结果表明,与非糖尿病患者相比,糖尿病患者冠状动脉心脏病(CHD)、DVD、TVD、弥漫性病变和冠状动脉血管明显狭窄的发病率较高。结论糖尿病患者冠状动脉粥样硬化的严重程度和不可预知表现的比例要高得多。由于病变形态复杂,经皮冠状动脉腔内成形术(PCI)和冠状动脉旁路移植术(CABG)等明确的介入治疗更加困难。糖尿病患者的风险因素较高,临床预后较差。早期诊断和适当治疗可降低发病后并发症的风险。大学心脏杂志,2023;19(1):5-9
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Coronary Angiographic Findings between Diabetic and nondiabetic Patients in Coronary Artery Disease: A Comparative Study
Background & Objectives: Coronary artery disease (CAD) accounts for the major risk factor of mortality in diabetes. Coronary angiography is the “gold-standard” technique for diagnosing and evaluating CAD. Material and Methods: The present study was undertaken at Border Guard hospital, Dhaka between the periods of November - 2017 to December 2021. Percutaneous coronary angiography (CAG) was performed in 204 consecutive patients with suggestive of ischaemic chest pain. The population consisted of 88 cases which are diabetic and 116 cases nondiabetic Results: We observed angiographic lesion among both groups comparing site & number of vessel(s) involvement and also average percentage of stenosis. The presence of coronary risk factors was not significantly different between the two populations. Total positive angiographic lesion was (61.5%) in both groups. Among the Diabetes mellitus patients positive CAG finding (69.3%). The recognized lesions were single vessel disease (SVD) 23 (26.1%), double vessel disease (DVD) 14 (15.9%), triple vessel disease (TVD) 24 (27.3%) percentage of vessel stenosis 82.63%. On the other hand, total positive angiographic lesion was 70 (53.4%) in non-diabetic group; among them single vessel disease (SVD) 30 (25.9%), double vessel disease (DVD) 15(12.9%), triple vessel disease (TVD) 17 (14.7%). No diffuse lesions was found and average vessel stenosis was 78.03%. The results of the angiographic finding suggest that diabetic patients have a higher incidence of coronary heart disease (CHD), DVD, TVD, diffuse lesion & marked stenosis of coronary vessel than non-diabetic patient. Conclusion: CAD in diabetics had considerably higher percent of severe and unpredictable presentation. This increased frequency of complex lesion morphology is more difficult to treat by definitive intervention like percutaneous transluminal coronary angioplasty (PCI) & coronary artery bypass graft (CABG). Diabetics have a higher risk factor profile and poor clinical outcome. Early diagnosis and appropriate management will reduce the risk of complication after the onset of disease. University Heart Journal 2023; 19(1): 5-9
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