摘要
目的 探讨早期糖代谢异常对冠状动脉 (冠脉 )血流储备的影响。方法 包括 2 5例糖耐量异常的胸痛但冠脉造影正常患者 (糖耐量异常组 )及 2 5例血糖正常且年龄、性别及一般情况匹配、冠脉造影正常的患者 (对照组 )。比较两组的血糖、胰岛素、糖化血红蛋白、纤维蛋白原、C 反应蛋白水平及冠脉血流储备功能。结果 糖耐量异常组空腹及糖耐量试验餐后 2h血糖显著高于对照组[分别为 :(6 5 4± 0 2 2 )mmol/L与 (5 18± 0 6 6 )mmol/L ;(10 6 3± 3 2 6 )mmol/L与 (9 0 9± 1 89)mmol/L ,P均 <0 0 0 1],前者糖化血红蛋白明显增高 [(6 32± 0 6 7) %与 (5 5 4± 1 2 3) %,P <0 0 5 ]。与对照组比较 ,糖耐量异常组基础冠脉血流平均峰值流速显著增高 [(2 2 6± 5 6 )cm/s与 (17 9± 4 9)cm/s,P <0 0 5 ],但腺苷激发后冠脉血流平均峰值流速 [(4 7 1± 13 8)cm/s与 (6 0 7± 15 3)cm/s ,P <0 0 5 ]和冠脉血流储备 (2 0 9± 0 31与 3 4 2± 0 5 5 ,P <0 0 0 1)显著减低。结论 早期糖代谢异常时 ,冠脉造影正常 ,但其冠脉血流储备常常减低。
Objective To assess coronary flow reserve(CFR) in patients with early abnormal glucose metabolism. Methods Twenty-five patients with impaired glucose tolerance and chest pain but without abnormal coronary arterial angiography (IGT group) and 25 age- and sex-matched patients with normal serum glucose level and coronary angiography (control group) were studied. Serum levels of glucose insulin, HbA1c, fibrinogen, c-reactive protein and CFR were compared between the two groups. Results The fasting glucose and postprandial (2 hours after 75 g oral glucose tolerance test) glucose concentrations were obviously higher in IGT group than in control [(6.54±0.22) mmol/L vs (5.18±0.66) mmol/L and (10.63±3.26) mmol/L vs (9.09±1.89) mmol/L, P<0.001, respectively). The HbA1c level was also higher in IGT group [(6.32±0.67)% vs (5.54±1.23)%, P<0.05]. Compared with control group the baseline average peak velocity (APV) was higher [(22.6±5.6) cm/s vs (17.9±4.9) cm/s,P<0.05], but peak APV after adenosine administration was lower in IGT group [(47.1±13.8) cm/s vs (60.7±15.3) cm/s, P<0.05], resulting in a reduced CFR in IGT group (2.09±0.31 vs 3.42±0.55, P<0.001). Conclusion Patients with impaired glucose tolerance often have a reduction in CFR although their coronary angiography is normal.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2001年第10期577-579,共3页
Chinese Journal of Cardiology
