【摘要】 目的 分析糖代谢异常合并冠心病(CAD)患者的冠状动脉造影(CAG)特点。 方法 选取CAG确诊为CAD的未知高血糖患者130例，对所有患者完成血压、血糖、FIns、血脂、体脂参数等测定。根据75gOGTT结果，分为糖耐量正常(NGT)组、负荷后2h糖耐量受损(IGT)组和初诊糖尿病(DM)组，比较分析其冠状动脉影像学的特点。 结果 IGT组和DM组冠状动脉病变支数、重度狭窄(77.5%和78.4% vs 56.6%)、弥漫性病变(40.0%和40.5% vs 17%)、右冠状动脉病变比例(67.5%和64.9% vs 41.5%)、病变总积分(5.275±1.768和5.865±2.720 vs 4.132±1.765)均高于NGT组(P<0.05或P<0.01);2hPG、HOMA-IR、WHR、载脂蛋白B(ApoB)、吸烟史、BMI、高血压病、CAD家族史是CAD的独立预测因素(P<0.01)。 结论 糖代谢异常患者冠状动脉病变的严重程度，随着糖代谢异常的加重而加剧，在DM前期已有凸显。

　　【关键词】 冠心病;糖代谢异常;冠状动脉造影

　　Coronary angiographicologic findings in patients with glucometabolic abnormality and coronary heart disease . LI Yong, LAI Xiao-yang. Department of Endocrinology & Metabolism, the Second Affiliated Hospital, Nanchang University, Nanchang 330006, China

　　Corresponding author: LAI Xiao-yang, E-mail: laixyang60@sina.com

　　【Abstract】Objective To analyze the characteristics of coronary angiographicologic (CAG) findings in patients with glucometabolic abnormality and coronary heart disease (CAD). Methods A total of 130 patients with CAD confirmed by CAG were included in this study. The blood pressure, blood glucose, fasting insulin (FIns), serum lipid profile, and body mass index (BMI) of all patients were determined. According to the result of 75gOGTT, they were divided into 3 groups: normal glucose tolerance (NGT) group, impaired glucose tolerance (IGT) group, and preclinical diabetes mellitus (PDM) group respectively for comparing the characteristics of CAG findings. Results Compared with the NGT patients, the IGT and PDM patients suffered more from multiple vessel lesions, severe coronary artery stenosis (77.5% and 78.4% vs 56.6%), diffuse lesions (40.0% and 40.5% vs 17%), the right coronary artery (RCA) lesions ( 67.5% and 64.9% vs 41.5%), and the cumulative scores (5.275±1.768 and 5.865±2.720 vs 4.132±1.765) (P<0.05 or P<0.01). The 2 hour plasma glucose (2hPG), insulin resistance index (HOMA-IR), waist-to-hip rate (WHR), apo-lipoprotein B (Apo-B), smoking, BMI, hypertension, family history of CAD were the independent predicting factors of CAD (P<0.01). Conclusions The coronary artery lesions are getting worse with the progress of glucometabolic abnormality, and this phenomenon is present in the impaired glucose tolerance period already.

　　【Key words】 Coronary heart disease; Glucometabolic abnormality; Coronary angiography