Araz M, Celen Z, Akdemir I, Okan V
Department of Internal Medicine, Medical Faculty, Gaziantep University, TR-27070, Gaziantep, Turkey.
Acta Diabetol. 2004 Jun;41(2):38-43. doi: 10.1007/s00592-004-0142-2.
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.
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。
