Objective To discuss characteristics of carotid artery lesion between diabetic patients and non-diabetic patients undergoing coronary artery reconstruction.Methods 461 patients who were to undergo coronary artery bypass grafting(CABG) in Beijing Anzhen Hospital,Capital Medical University from January 2014 to June 2015 were selected,and were divided into diabetic group(n=223) and non-diabetic group(n=238).Preoperative carotid artery ultrasonography was used to assess the status of carotid artery lesion of and the characteristics of carotid artery lesions in both groups were analyzed.Results There was no significant difference in gender,average age,incidence of hypertension and family history of ischemic heart disease between the two groups(P>0.05).The history of smoking in diabetic group was lower than that in non-diabetic group,and the difference was statistically significant(P<0.05).The incidence of dyslipidemia,history of cerebrovascular accident and transient ischemic attack(TIA) in diabetic group was higher than that in non-diabetic group(P<0.05).The incidence of left main branch stenosis,diffuse stenosis of left anterior descending branch and left circumflex artery stenosis≥ 50% in diabetic group was higher than that of non-diabetic group(P<0.05).The incidence of left anterior descending artery stenosis≥ 50%,left circumflex diffuse stenosis,right coronary artery diffuse stenosis,right coronary artery stenosis≥ 50%,atrial interventricular diffuse stenosis and atrial intermediate branch stenosis≥ 50% was not significantly different between two groups(P>0.05).The incidence of carotid artery in diabetic group was higher than that in non-diabetic group.The incidence of carotid artery stenosis≥ 50% in diabetic group was significantly higher than that in non-diabetic group(P<0.05).Among them,the incidence of right common carotid artery stenosis of 50% to 69%,right carotid artery stenosis of 50% to 69%,left common carotid artery stenosis of 50% to 69%,left internal carotid artery stenosis ≥ 70%,left carotid artery stenosis of 50% to 69%,left carotid artery stenosis ≥ 70% in diabetic group was significantly higher than that in non-diabetic group(P<0.05).There was no significant difference in the incidence of right common carotid artery stenosis≥ 70%,right internal carotid artery stenosis of 50% to 69%,right internal carotid artery stenosis≥ 70%,right carotid artery stenosis ≥ 70%,left common carotid artery stenosis ≥ 70%,left internal carotid artery stenosis of 50% to 69% between two groups(P>0.05).Conclusion The risk of diabetic patients after CABG developing severe carotid artery stenosis is higher than non-diabetic patients,and the main combined branches are left and right common carotid arteries and internal carotid artery.%目的 探讨行冠状动脉重建术的糖尿病与非糖尿病患者颈动脉病变特点.方法 选取2014年1月-2015年6月首都医科大学附属北京安贞医院收治的因冠心病准备行冠状动脉旁路移植(CABG)术的患者461例,根据是否合并糖尿病分为糖尿病组(n=223)和非糖尿病组(n=238).术前采用颈动脉超声检查评估患者的颈动脉病变情况,并分析两组患者的颈动脉病变特点.结果 两组患者性别、平均年龄、合并高血压、缺血性心脏病家族史比较,差异无统计学意义(P>0.05);糖尿病组患者吸烟史低于非糖尿病组,合并血脂异常、脑血管意外史、短暂性脑缺血发作(TIA)史高于非糖尿病患者,差异有统计学意义(P<0.05).糖尿病组患者左主干狭窄、左回旋支≥50%狭窄、左前降支弥漫性狭窄发生率高于非糖尿病组,差异有统计学意义(P<0.05);两组患者左前降支≥50%狭窄、左回旋支弥漫性狭窄、右冠状动脉弥漫性狭窄、右冠状动脉≥50%狭窄、心房中间支弥漫性狭窄、心房中间支≥50%狭窄发生率比较,差异无统计学意义(P>0.05).糖尿病组患者颈动脉病变程度高于非糖尿病组,颈动脉≥50%狭窄发生率高于非糖尿病组,差异有统计学意义(P<0.05).其中,糖尿病组患者右颈总动脉50%~69%狭窄、右颈动脉50%~69%狭窄、左颈总动脉50%~69%狭窄、左颈内动脉≥70%狭窄、左颈动脉50%~69%狭窄发生率高于非糖尿病组,差异有统计学意义(P<0.05);两组患者右颈总动脉≥70%狭窄、右颈内动脉50%~69%狭窄、右颈内动脉≥70%狭窄、左颈动脉≥70%狭窄、右颈动脉≥70%狭窄、左颈总动脉≥70%狭窄、左颈内动脉50%~69%狭窄发生率比较,差异无统计学意义(P>0.05).结论 行冠状动脉重建术的糖尿病患者发生严重颈动脉狭窄的风险高于非糖尿病患者,主要合并分支为左右颈总动脉和颈内动脉.
展开▼
