糖化血红蛋白水平与冠状动脉病变支数及心功能的相关性研究

The correlation of glycosylated hemoglobin levels with coronary vessels diseased and cardiac function

目的：探讨血清糖化血红蛋白（HbA1c）水平与冠心病患者冠状动脉病变支数和心功能的关系。方法对253例入住我院并接受冠状动脉造影检查确诊为冠心病的患者，按HbAlc水平分为3组：正常组（HbA1c≤5.6％，n=75）、临界组（HbA1c 5.7％～6.4％，n=85）、升高组（HbA1c≥6.5%，n=89）。根据冠状动脉病变支数分为单支病变组（n＝95）、双支病变组（n＝103）和多支病变组（n＝55），分析HbA1c水平与冠状动脉病变支数及心功能的相关性。结果 HbAlc水平与冠状动脉病变支数呈正相关（r=0.75，P＜0.01）。HbAlc水平三支病变组高于双支病变组，双支病变组高于单支病变组，临界组和升高组的左心室舒张末期内径（LVEDd）及B型脑钠肽（BNP）均高于正常组，左心室射血分数（LVEF）均低于正常组，升高组的LVEDd及BNP高于临界组、LVEF低于临界组（均P＜0.01）。HbAlc水平与LVEDd及BNP水平均呈正相关（r=0.73、0.62，均P＜0.05），与LVEF呈负相关（r=-0.58，P＜0.05）。结论 HbAlc增高者冠状动脉病变支数较多，左心室腔较大，心功能较差。

Objective To investigate the correlation of glycosylated hemoglobin with the number of coronary vessels diseased and cardiac function in patients with coronary artery disease （CAD）. Methods 253 patients with CAG determined by coronary angiography were divided into normal group （n=75, HbA1c≤5.6%）, borderline group （n=85, HbA1c 5.7%~6.4%） and abnormal group （HbA1c≥6.5%, n=89） based on HbA1c. Of them, 95 cases had single- vessel disease, 103 had two- vessel disease and 55 had multi- vessel disease. The relation of HbAlc with the number of coronary vessels diseased and cardiac function was analyzed. Results HbAlc was positively correlated with the number of coronary vessels diseased （r=0.75, P〈0.01）, and highest in patients with three- vessel disease and lowest in those with single- vessel disease. Left ventricular end- diastolic diameter（LVEDd） and B- type natriuretic peptide（BNP） increased and left ventricular ejection function （LVEF） decreased from normal group to borderline group to abnormal group with a significant difference between groups （al P〈0.01）. HbAlc was positively correlated with LVEDd and NBP （r=0.73、0.62, P〈0.05） and negatively correlated with LVEF （r=- 0.58, P〈0.05）. Conclusion Patients with HbAlc increased have more coronary vessels diseased, a larger left ventricle and impaired heart function.