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心绞痛的存在与糖尿病患者广泛的冠状动脉疾病有关。

Presence of angina pectoris is related to extensive coronary artery disease in diabetic patients.

机构信息

Faculty of Medicine, Department of Cardiology, Gaziosmanpasa University, Tokat, Turkey.

出版信息

Clin Cardiol. 2013 Aug;36(8):475-9. doi: 10.1002/clc.22151. Epub 2013 Jun 10.

Abstract

BACKGROUND

Due to sensorial autonomic neuropathy, the type and severity of angina pectoris in patients with diabetes mellitus (DM) may be rather different from the type and severity of angina pectoris in patients without DM.

HYPOTHESIS

The aim of the study was to understand if angina pectoris is related to extensive coronary artery disease (CAD) in patients with DM.

METHODS

The study included 530 patients with DM who underwent coronary angiography at our center in 2009 and 2010. Patients were divided into 4 groups according to type of chest pain: group 1, noncardiac chest pain or no pain; group 2, angina equivalent; group 3, atypical angina; and group 4, typical angina. All angiograms were re-evaluated and Gensini scores were calculated. Three-vessel disease was diagnosed in the presence of stenosis >50% in all 3 coronary artery systems.

RESULTS

There were no statistically significant differences between the groups with regard to age, sex, systolic or diastolic blood pressures, body mass index, creatinine clearance, or lipid profile. Fasting blood glucose was significantly higher in group 4 than in group 2. Gensini scores were not statistically different between groups 1 and 2 or between groups 3 and 4; however, the scores for groups 3 and 4 were higher than the score for either group 1 or group 2. Prevalence of 3-vessel disease was significantly higher in groups 3 and 4 compared with the other groups.

CONCLUSIONS

The presence of angina pectoris was related to extensive CAD in patients with DM. The extent of CAD was not correlated with the type of angina (typical or atypical).

摘要

背景

由于感觉自主神经病变,糖尿病患者的心绞痛类型和严重程度可能与非糖尿病患者的心绞痛类型和严重程度有很大不同。

假说

本研究旨在了解糖尿病患者的心绞痛是否与广泛的冠状动脉疾病(CAD)有关。

方法

本研究纳入了 2009 年至 2010 年在我们中心接受冠状动脉造影的 530 例糖尿病患者。根据胸痛类型将患者分为 4 组:组 1,非心源性胸痛或无胸痛;组 2,等效性心绞痛;组 3,非典型心绞痛;组 4,典型心绞痛。所有的血管造影都重新进行了评估,并计算了 Gensini 评分。三血管疾病的诊断标准为所有 3 个冠状动脉系统的狭窄>50%。

结果

各组在年龄、性别、收缩压或舒张压、体重指数、肌酐清除率或血脂谱方面无统计学差异。组 4 的空腹血糖明显高于组 2。组 1 和组 2 之间或组 3 和组 4 之间的 Gensini 评分无统计学差异;然而,组 3 和组 4 的评分高于组 1 或组 2。与其他组相比,组 3 和组 4 的三血管疾病患病率明显更高。

结论

糖尿病患者存在心绞痛与广泛的 CAD 有关。CAD 的严重程度与心绞痛的类型(典型或非典型)无关。

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本文引用的文献

2
Standards of medical care in diabetes--2011.《糖尿病医疗护理标准——2011 年》
Diabetes Care. 2011 Jan;34 Suppl 1(Suppl 1):S11-61. doi: 10.2337/dc11-S011.

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