本文選題：糖尿病 + 頸動(dòng)脈狹窄　； 參考：《中國(guó)全科醫(yī)學(xué)》2017年13期

【摘要】：目的探討行冠狀動(dòng)脈重建術(shù)的糖尿病與非糖尿病患者頸動(dòng)脈病變特點(diǎn)。方法選取2014年1月—2015年6月首都醫(yī)科大學(xué)附屬北京安貞醫(yī)院收治的因冠心病準(zhǔn)備行冠狀動(dòng)脈旁路移植(CABG)術(shù)的患者461例,根據(jù)是否合并糖尿病分為糖尿病組(n=223)和非糖尿病組(n=238)。術(shù)前采用頸動(dòng)脈超聲檢查評(píng)估患者的頸動(dòng)脈病變情況,并分析兩組患者的頸動(dòng)脈病變特點(diǎn)。結(jié)果兩組患者性別、平均年齡、合并高血壓、缺血性心臟病家族史比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);糖尿病組患者吸煙史低于非糖尿病組,合并血脂異常、腦血管意外史、短暫性腦缺血發(fā)作(TIA)史高于非糖尿病患者,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。糖尿病組患者左主干狹窄、左回旋支≥50%狹窄、左前降支彌漫性狹窄發(fā)生率高于非糖尿病組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者左前降支≥50%狹窄、左回旋支彌漫性狹窄、右冠狀動(dòng)脈彌漫性狹窄、右冠狀動(dòng)脈≥50%狹窄、心房中間支彌漫性狹窄、心房中間支≥50%狹窄發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。糖尿病組患者頸動(dòng)脈病變程度高于非糖尿病組,頸動(dòng)脈≥50%狹窄發(fā)生率高于非糖尿病組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。其中,糖尿病組患者右頸總動(dòng)脈50%~69%狹窄、右頸動(dòng)脈50%~69%狹窄、左頸總動(dòng)脈50%~69%狹窄、左頸內(nèi)動(dòng)脈≥70%狹窄、左頸動(dòng)脈50%~69%狹窄發(fā)生率高于非糖尿病組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者右頸總動(dòng)脈≥70%狹窄、右頸內(nèi)動(dòng)脈50%~69%狹窄、右頸內(nèi)動(dòng)脈≥70%狹窄、左頸動(dòng)脈≥70%狹窄、右頸動(dòng)脈≥70%狹窄、左頸總動(dòng)脈≥70%狹窄、左頸內(nèi)動(dòng)脈50%~69%狹窄發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論行冠狀動(dòng)脈重建術(shù)的糖尿病患者發(fā)生嚴(yán)重頸動(dòng)脈狹窄的風(fēng)險(xiǎn)高于非糖尿病患者,主要合并分支為左右頸總動(dòng)脈和頸內(nèi)動(dòng)脈。
[Abstract]:Objective to investigate the characteristics of carotid artery lesions in diabetic and non-diabetic patients undergoing coronary artery reconstruction. Methods from January 2014 to June 2015, 461 patients with coronary artery bypass grafting (CABG) who were treated in Beijing Anzhen Hospital affiliated to Capital Medical University were divided into two groups: diabetes mellitus group (n = 223) and non-diabetic group (n = 238). Carotid artery lesions were evaluated by carotid ultrasound before operation and the characteristics of carotid artery lesions were analyzed in both groups. Results there was no significant difference in the family history of hypertension and ischemic heart disease between the two groups (P0.05). The history of transient ischemic attack (TIA) was higher than that of non-diabetic patients (P0.05). The incidence of left main stenosis, left circumflex branch 鈮，

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