2型糖尿病患者无症状性心肌缺血的发生率及其与血糖控制不佳的关系。

Frequency of silent myocardial ischemia in type 2 diabetic patients and the relation with poor glycemic control.

作者信息

Araz M, Celen Z, Akdemir I, Okan V

机构信息

Department of Internal Medicine, Medical Faculty, Gaziantep University, TR-27070, Gaziantep, Turkey.

出版信息

Acta Diabetol. 2004 Jun;41(2):38-43. doi: 10.1007/s00592-004-0142-2.

DOI:10.1007/s00592-004-0142-2

PMID:15224203

Abstract

The aim of the study was to investigate the frequency of silent myocardial ischemia in type 2 diabetic patients without any clinical or laboratory findings of myocardial ischemia and to examine the related factors for silent myocardial ischemia. A total of 116 type 2 diabetic patients (82 women) with a disease duration of 5-20 years were included in the study. All patients underwent stress and resting myocardial perfusion single-photon emission computed tomographic (SPECT) study with (99m)Tc-MIBI. Coronary angiography was performed in patients with ischemia established at myocardial perfusion SPECT. Ischemia was determined in 18 (15.5%) patients by myocardial perfusion SPECT. Coronary angiography performed in 17 of these patients confirmed coronary stenosis >50% in 11 patients. Thus, the prevalence of silent myocardial ischemia was 9.6%. Significant relations were found between silent myocardial ischemia and male sex, high HbA(1C) level and retinopathy. Type 2 diabetic patients (especially men) with poorly controlled diabetes mellitus or retinopathy should be screened for silent myocardial ischemia.

摘要

本研究的目的是调查无任何心肌缺血临床或实验室检查结果的2型糖尿病患者无症状心肌缺血的发生率，并探讨无症状心肌缺血的相关因素。共有116例病程为5至20年的2型糖尿病患者（82例女性）纳入本研究。所有患者均接受了用（99m）Tc-MIBI进行的负荷及静息心肌灌注单光子发射计算机断层扫描（SPECT）检查。对心肌灌注SPECT检查发现有缺血的患者进行了冠状动脉造影。心肌灌注SPECT检查确定18例（15.5%）患者存在缺血。对其中17例患者进行的冠状动脉造影证实11例患者冠状动脉狭窄>50%。因此，无症状心肌缺血的患病率为9.6%。发现无症状心肌缺血与男性、高糖化血红蛋白A1C（HbA1C）水平及视网膜病变之间存在显著相关性。2型糖尿病患者（尤其是男性）若糖尿病或视网膜病变控制不佳，应筛查无症状心肌缺血。