通过跑步机运动试验和冠状动脉造影判断非胰岛素依赖型糖尿病患者的无症状心肌缺血。

Silent myocardial ischemia in patients with non-insulin-dependent diabetes mellitus as judged by treadmill exercise testing and coronary angiography.

作者信息

Naka M, Hiramatsu K, Aizawa T, Momose A, Yoshizawa K, Shigematsu S, Ishihara F, Niwa A, Yamada T

机构信息

Department of Medicine, Asama General Hospital, Nagano-ken, Japan.

出版信息

Am Heart J. 1992 Jan;123(1):46-53. doi: 10.1016/0002-8703(92)90745-h.

DOI:10.1016/0002-8703(92)90745-h

PMID:1729850

Abstract

Patients with diabetes were compared with nondiabetic control subjects, with respect to the prevalence of silent myocardial ischemia, by means of treadmill exercise testing and coronary angiography. Results of treadmill exercise testing showed ischemic ST depression in 41 of the 132 diabetic patients (mean age 61 +/- 4 years) and in 42 of the 140 nondiabetic control subjects (mean age 60 +/- 8 years) (31% vs 30%, p = NS). Coronary angiography was performed in 36 of 41 diabetic patients and 34 of 42 nondiabetic control subjects with positive results of treadmill exercise tests, who gave their consent. Among "treadmill-positive" subjects, diabetic patients had a prevalence of silent myocardial ischemia that was 2.2 times higher than that in nondiabetic control subjects (p less than 0.05). Diabetic patients who received insulin had a 2.6 times higher prevalence of silent myocardial ischemia than those who did not (p less than 0.05). Similarly diabetic patients with retinopathy has a 2.5 times higher prevalence of silent myocardial ischemia than those without it (p less than 0.05).

摘要

通过跑步机运动试验和冠状动脉造影，对糖尿病患者和非糖尿病对照受试者在无症状心肌缺血患病率方面进行了比较。跑步机运动试验结果显示，132例糖尿病患者（平均年龄61±4岁）中有41例出现缺血性ST段压低，140例非糖尿病对照受试者（平均年龄60±8岁）中有42例出现缺血性ST段压低（31%对30%，p=无显著性差异）。对41例糖尿病患者中的36例以及42例非糖尿病对照受试者中的34例跑步机运动试验结果呈阳性且同意进行检查的患者进行了冠状动脉造影。在“跑步机运动试验阳性”的受试者中，糖尿病患者无症状心肌缺血的患病率比非糖尿病对照受试者高2.2倍（p<0.05）。接受胰岛素治疗的糖尿病患者无症状心肌缺血的患病率比未接受胰岛素治疗的患者高2.6倍（p<0.05）。同样，患有视网膜病变的糖尿病患者无症状心肌缺血的患病率比未患视网膜病变的患者高2.5倍（p<0.05）。