冠心病患者糖化血红蛋白水平与冠状动脉病变的相关性

Correlation between the level of glycosylated hemoglobin A1c and the extent of coronary lesions in patients with coronary heart disease

目的:探讨糖化血红蛋白(HbA1c)水平与冠状动脉病变严重程度的关系及意义.方法:收集97例冠心病患者,其中单纯冠心病组32例,冠心病合并糖耐量异常(IGT)组31例,冠心病合并2型糖尿病(T2DM)组34例,所有患者均采用放射免疫法测定HbA1c,根据住院期间冠状动脉造影(CAG)结果,采用冠脉狭窄程度积分统计冠脉狭窄程度,作为冠脉病变程度的指标.结果:冠心病合并T2DM组的糖化血红蛋白水平及冠脉狭窄程度积分均较单纯冠心病组及冠心病合并IGT组明显升高(P<0.05);冠心病合并IGT组明显高于单纯冠心病组(P<0.05);相关分析显示,糖化血红蛋白水平与冠脉病变积分呈正相关(r=0.6447,P<0.01),在剔除了其他常见影响因素后这种相关性仍然存在.结论:HbA1c水平与冠脉病变程度积分呈正相关.HbA1c水平升高是冠心病的独立危险因素.

AIM： To explore the correlation between the level of glycosylated hemoglobin Alc （HbAlc） and the extent of coronary lesions in coronary heart disease （CHD）. METHODS： Ninetyseven CHD patients were included in the study： simple CHD group （n=32 ）, CHD accompanied with impaired glucose tolerance （IGT） group （n=31） and CHD accompanied with type 2 diabetes mellitus （T2DM） group （ n=34 ）. The levels of HbAlc of all the patients were analyzed by radio immunoassay. All the patients underwent coronary angiography and the extent of coronary lesions was analyzed by total amount of coronary narrow degree integral. ERSULTS： The levels of HbAlc and coronary artery narrow degree in CHD accompanied with T2DM group were significantly higher than those of simple CHD group and CHD accompanied with IGT group （ P〈0. 05 ） ; those of CHD accompanied with IGT group were significantly higher than those of simple CHD group （ P〈0.05 ） ; correlation analysis showed that the level of HbA1 c was positively correlated with the coronary artery narrow degree in CHD patients （ r=0. 6447, P 〈 0.01 ）. CONCLUSION： The level of HbAlc was positively correlated with the coronary artery narrow degree in CHD patients. The higher level of HbA1 c was the independent dangerous factor for CHD.