急性冠脉综合征糖代谢异常与高敏C反应蛋白的关系

The case control study on the relation between level of Hs-CRP and glycometabolic disturbance in patients with acute coronary syndrome

目的探讨急性冠脉综合征患者糖代谢异常与高敏C反应蛋白的关系。方法急性冠脉综合征(ACS)患者155例分糖耐量正常A组、糖耐量异常B组、糖尿病C组,测定血糖(FBG、PBG)、胰岛素(FINS、PINS)、糖化血红蛋白(HbA1c)、高敏C反应蛋白(hs-CRP)、血脂等指标,95例做了冠状动脉造影。结果进行统计分析,比较三组的高敏C反应蛋白、胰岛素、糖化血红蛋白、血脂水平及冠脉病变。结果C组、B组与A组的Hs-CRP、FBG、PBG、FINS、PINS、HbA1c、TC、LDL-C等生化指标比较差异有统计学意义;C组和B组的PINS、TC水平差异无统计学意义;Hs-CRP的水平与PBG、PINS、HbA1c、TC、LDL-C相关。B和C组的冠状动脉造影显示病变更为严重,多支血管病变的发生率明显高于A组;多支血管病变的发生率在B组和C组间差异无统计学意义。结论与糖代谢正常的ACS患者相比,合并糖代谢异常的ACS患者有更高的高敏C反应蛋白水平,冠脉病变更为严重。

Objective To discuss the relation between level of Hs-CRP and glycometabolic disturbance in patients with acute coronary syndrom. Methods 155 patients with acute coronary syndrome were divided into 3 groups according to the WHO standard of diabetes diagnosis, normal glucose tolerance group（group A,44 cases）, impaired glucose tolerance group（group B ,60 cases）,diabetes group（group C, 51 eases）. All eases were checked by the 75g glucose tolerance test, blood Glucosc, insulin, HbA1 c, lipid, hypersensitive C reaction protein （hs-CRP）. 95 patients were checked by coronary angiography（CAG）. Statistic comparison were measured among three groups including the levels of hs-CRP, insulin, HbA1c, lipid and coronary artery lesions. Results The levels of Hs-CRP, PBG, FINS,PINS, HbA1c,TC, LDL-C in both group B and C were higher than those in group A;The levels of TG. PLNS were not found significant differences between group B and C. The level of Hs-CRP was correlated with the levels of PBG,PINS,HbA1c,TC, LDL-C. The coronary artery lesions showed by CAG in group B and C were more severe than those in group A, coronary multivessel changes in group B and C were more frequent than in group A, it had no significant difference between group B and C.Conchlsion Compared with the patients of normal glucose tolerance, patients with glycometabolic disturbance have higher levels of hs-CRP, their coronary artery lesions are more severe.