冠心病患者糖化血红蛋白水平与冠状动脉病变程度的相关性研究

Correlation between HbA 1c Level and Coronary Artery Disease Severity

目的研究不同糖代谢情况的冠心病患者糖化血红蛋白(HbA1c)水平与冠状动脉病变程度的关系。方法回顾性分析某三级甲等医院心内科2009年2月—2011年10月行冠状动脉造影(CAG)明确诊断为冠心病的患者2 336例。根据糖代谢情况分为3组,即冠心病伴糖耐量正常组(正常组)970例、冠心病伴糖耐量异常组(异常组)781例和冠心病伴糖尿病组(糖尿病组)585例。对3组患者的一般资料进行比较,分析HbA1c水平、冠状动脉狭窄程度及冠状动脉病变支数之间的相关性和冠状动脉病变的危险因素。结果 3组患者在冠状动脉狭窄程度、冠状动脉病变支数、年龄、空腹血糖(FPG)、餐后2 h血糖(2 h PG)、HbA1c、三酰甘油(TG)方面比较,差异有统计学意义(P<0.05)。经Spearman秩相关分析显示,HbA1c水平与冠状动脉狭窄程度,冠状动脉狭窄程度与冠状动脉病变支数之间均呈正相关(rs=0.705,0.120;P<0.01)。采用Logistic回归分析冠状动脉病变的危险因素,结果显示,年龄、性别、高血压、HbA1c、FPG、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)进入回归方程。结论 HbA1c水平与冠状动脉狭窄程度以及冠状动脉病变支数之间存在显著的相关性,是影响冠状动脉病变严重程度的重要因素。

Objective To investigate the relationship of glycosylated hemoglobin （ HbA1c ） to the severity of coronary artery disease （CAD）. Methods A total of 2 336 CAD patients from February 2009 to October 2011 were divided, according to level of glucose metabolism, into groups A （ CAD with normal glucose tolerance, n = 970）, B （ CAD with abnormal glucose tolerance, n =781 ）, C （CAD with diabetes, n = 585）. General information was compared in the 3 groups, correlation of HbAlo level, coronary artery stenosis （CAS） with the number of damaged coronary arteries and the risk factors of CAD were ana- lyzed. Results There was significant difference in CAS, number of damaged coronary arteries, age, fasting plasma glucose （ FPG）, 2h postprandial glucose, glycosylated hemoglobin （ HbA1c ）, triglyceride （TG） in the 3 groups （ P 〈 0. 05 ）. By Spearman correlation analysis, HbA1c level was positively correlated with CAS and CAS positively with number of damaged coro- nary arteries （rs = 0. 705, 0. 120; P 〈 0.01）. By Logistic regression analysis, age, gender, hypertension, HbA1c, FPG, TC, HDL - C were risk factors of CAD. Conclusion HbA1c, remarkably correlated with CAS and number of damaged coronary arteries, is an important indicator influencing severity of CAD.