冠心病合并糖耐量受损患者糖化血红蛋白水平与冠脉病变的相关性研究

The Relation of Glycosylated Hemoglobin Level With Coronary Lesion In Patients With Coronary Heart Disease and Impaired Glucose Tolerance

目的探讨冠心病合并糖耐量受损患者糖化血红蛋白水平(HbA1c)与冠脉病变的相关性。方法 213例经冠脉造影确诊冠心病患者,根据口服75g葡萄糖耐量试验结果,分为糖耐量正常的单纯冠心病组(NGT组)110例;冠心病合并糖耐量受损组(IGT组)103例。冠状动脉造影结果采用Gensini评分。结果 IGT组HbA1c水平、Gensini积分明显高于NGT组(P<0.05);IGT组重度狭窄(76-100%)及多支病变高于NGT组(P<0.05)。Spearman等级相关分析提示,体重指数、餐后2h血糖、甘油三酯、低密度脂蛋白胆固醇、高敏C反应蛋白、HbA1c与Gensini积分正相关。以Gensini积分为因变量进行多元回归分析,结果显示:HbA1c对冠脉狭窄程度有独立的预测价值。结论冠心病合并糖耐量受损患者HbA1c与冠脉狭窄程度呈正相关,而且可作为其独立预测指标。

Objective To examine the glycosylated hemoglobin Alc（HbAlc） levels and coronary arteries＇ Gensini scores in patients with coronary heart disease and impaired glucose tolerance（IGT）. Methods 213 inpatients who diagnosised coronary heart disease by coronary angiography were studied. All patients were classified as follows depending on the results of a 75 g oral glucose tolerance test：normal glucose tolerance group （NGT） （n=110）,IGT group （n= 103）. The severity of coronary stenosis was evaluated using the Gensini score, the correlation between the level of HbAlc and the Gensini score was analyzed. Results The levels of HbAlc and Gensini score of IGT group were significantly higher than NGT group （P〈0.05）;The-coronary severe stenosis （76-100%） and Multi-vessel lesion of IGT group were significantly higher than those of NGT group（P〈0.05）. Spearman rank correlation analysis showed that Gensini score had positive correlation with BMI,2 h postprandial glueose,TG,LDL-C,hs-CRP and HbAlc. After multi ple regression analysis, we got that HbAlc was the best independefit predictor for the coronary artery stenosis. Conclusion The level of HbAlc was positively correlated with the coronary narrow degree in patients with coronary heart disease and IGT. The level of HbAlc was the independent predictor for the severity of coronary stenosis in patients with coronary heart disease and IGT.