| Objective: The prevalence of coronary heart disease(CHD)with type 2 diabetes mellitus(T2DM)increased year by year,which is one of the main causes of death in the world,caused a huge burden of disease.With dyslipidemia in patients with T2 DM of coronary artery lesions may play a key role in the process of development,this study proposed by understanding coronary CHD with blood lipid levels and clinical features of patients with T2 DM,analyze its correlation with the severity of coronary artery lesions,predictors of blood lipid as the degree of coronary artery lesions in application value.Methods: Clinical information and coronary angiography results of suspected CHD patients admitted to the department of cardiovascular medicine of Qiqihaer No.1 hosipital in Heilongjiang province from January 2016 to December 2018 were collected.184 patients with CHD and T2 DM diagnosed by coronary angiography were included in the study group,while 143 patients with CHD but no T2 DM were included in the study control group.General data were collected including age,gender,history of smoking and alcohol consumption,history of hypertension,and laboratory tests including Total Cholesterol(TC),Triglyceride(TG),High Density Lipoprotein Cholesterol(HDL-c),Low Density Lipoprotein Cholesterol(LDL-c).Lipoprotein(a)[Lp(a)],Apolipoprotein A1(Apo A1),Apolipoprotein B(Apo B),and Hypersensitive c-reactive Protein(hs-CRP),Serum Uric Acid(SUA),Serum creatinine(Scr)and other detection indicators.SPSS24.0 statistical software was used for data analysis.The mean ± standard deviation or frequency(composition ratio)[n(%)] was used to describe the data,using independent sample t test or chi-square test for coronary heart disease with type 2 diabetes group and simple coronary heart disease The group was compared between groups,and the blood lipid index and other indicators of patients with different lesions and different severity groups were compared.The correlation between blood lipids and Gensini score was analyzed by multiple linear regression.Results: 1.The average age of patients with CHD combined T2 DM group was higher than in patients with simple CHD group(P < 0.05),Body Mass Index(BMI)in patients with T2 DM group CHD merger(Body Mass Index,BMI)average is lower than the pure patients with CHD group(P < 0.05),the CHD combined T2 DM patients with high blood pressure than simple CHD group(P < 0.05),patients with CHD combined T2 DM group smoke more than simple CHD group(113 > 59,P < 0.05),The chd-t2 dm group had more drinking patients than CHD group(P<0.05),and the chd-t2 dm group had more family history of CHD than CHD group(P<0.05).There was no significant difference between CHD patients with T2 DM and those with CHD alone in terms of gender and history of ischemic disease(P>0.05).2.TC,TG,ldl-c,Apo B,Apo B/A1,Lp(a),hs-CRP,SUA,fibrinogen concentration and prothrombin time in the CHD-combined T2 DM group were all higher than those in the CHD group alone,with statistically significant differences(P < 0.05).Hdl-c and Apo A1 levels in the CHD-combined T2 DM group were lower than those in the CHD group alone,with statistically significant differences(P < 0.05).Gensini score of CHD-combined with T2 DM group was higher than that of CHD alone group,and the difference was statistically significant(P < 0.05).There was no significant difference in Scr,SUN,TB,GPT and other indicators between CHD combined with T2 DM group and CHD alone group(P>0.05).3.In the CHD combined with T2 DM group,the age and BMI mean values of the patients in the single-vessel disease subgroup were lower than those in the multi-vessel disease subgroup,and there was a statistical difference(P<0.05).The number of patients with hypertension and smoking in the single-branch disease subgroup was lower than that in the multiple-branch disease subgroup,and the difference was statistically significant(P<0.05).There was no statistical difference between the sex of single branch lesion subgroup and multiple branch lesion subgroup(P>0.05).TC,TG,ldl-c,Apo B,Apo B/A1,Lp(a),hs-CRP,and SUA in the single-branch lesion subgroup were all lower than those in the multi-branch lesion subgroup,and there were statistical differences(P<0.05).Hdl-c and Apo A1 in the single-vessel disease subgroup were higher than those in the multi-vessel disease subgroup,and the difference was statistically significant(P<0.05).The Gensini score of coronary artery in the single-branch group was lower than that in the multi-branch group,and the difference was statistically significant(P<0.05).4.In the CHD combined with T2 DM group,there was no statistically significant difference in gender between the mild subgroup and the severe subgroup(P>0.05),and the average age and BMI of the mild subgroup were lower than those of the severe subgroup(P<0.05).The number of patients with hypertension and smoking in the mild disease subgroup was lower than that in the severe disease subgroup,and there was a statistical difference(P<0.05).TC,TG,ldl-c,Apo B,Apo B/A1,Lp(a),and hs-CRP and SUA in the severe lesion subgroup were all higher than those in the mild lesion subgroup,with statistical differences(P<0.05).The Apo A1,hdl-c,Scr,TB,SUN and GPT in the mild lesion subgroup were all higher than those in the severe lesion subgroup,and there were statistical differences(P<0.05).Gensini score of severe coronary artery disease subgroup was higher than that of mild coronary artery disease subgroup,and the difference was statistically significant(P<0.05).5.TC,TG,ldl-c,Apo B,Apo B/A1,Lp(a)and hs-CRP were positively correlated with coronary Gensini score,with correlation coefficients of 0.902,0.918,0.874,0.930,0.926,0.918 and 0.701,respectively,and P<0.05.Hdl-c,Apo A1 and coronary Gensini scores were negatively correlated with-0.888 and-0.960,respectively,and P<0.05.Conclusion: 1.In all patients(327 cases),age,BMI,hypertension,smoking,alcohol consumption and family history of CHD were correlated with the incidence of CHD complicated with T2 DM,while gender and ischemic disease history were not correlated with the incidence of CHD complicated with T2 DM.The coronary Gensini score of CHD combined with T2 DM group was higher than that of CHD alone group.2.In patients with CHD complicated with T2DM(184 cases),age,BMI,hypertension,smoking,various blood lipid indexes,SUA and hs-CRP were related to patients with different number of coronary artery lesions and severity of lesions,while gender,ischemic disease history and family CHD history were not related to severity of lesions.3.In CHD patients with T2DM(184 cases),coronary Gensini score was positively correlated with TC,TG,ldl-c,Apo B,Apo B/A1,Lp(a)and hs-CRP.Hdl-c,Apo A1 and coronary Gensini scores were negatively correlated. |
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