急性冠状动脉综合征患者高敏C反应蛋白与糖化血红蛋白的相关性研究

Clinical investigation of high sensitivity C-reactive protein and hemoglobin Alc in acute coronary syndrome

目的探讨急性冠状动脉综合征（ACS）患者血浆高敏C反应蛋白（hs-CRP）和糖化血红蛋白（HbA1c）水平与冠状动脉病变严重程度的关系及hs-CRP与HbA1c的相关性。方法选择因ACS行冠状动脉造影术患者80例（ACS组），其中急性心肌梗死（AMI）33例，不稳定型心绞痛（UA）47例。按病变支数分为单支病变组（27例），双支病变组（23例），j支病变组（30例）。另选择因怀疑冠心病行冠状动脉造影术排除冠心病的患者32例作为对照组。以液相层析法检测HbA1c浓度，以乳胶免疫增强比浊法检测hs-CRP浓度。结果ACS组和其中的单支、双支、3支病变组以及AMI组、UA组的hs-CRP水平均明显高于对照组[（7．85±5．89）、（4．49±2．68）、（8．79±5．09）、（9．37±5．49）、（10．93±4．56）、（4．89±2．09）mg／L比（1．56±1．03）mg／L，均P〈0．01]，HbA1c水平与对照组比较差异均无统计学意义[（6．48±1．32）％、（6．33±1．60）％、（6．54±1．68）％、（6．79±1．32）％、（6．49±1．46）％、（6．52±1．32）％比（6．32±1．20）％，均P〉0．05]。hs-CRP与病变支数、病变类型呈正相关（r=0．63，r=0．74，均P〈0．01）。HbA1c与病变支数和病变类型无相关性（r=0．09，r=0．06，均P〉0．05）？结论ACS患者中血浆hs-CRP水平升高，hs-CRP与冠状动脉病变不稳定程度具相关性。HbAIC不能反映冠状动脉病变的不稳定程度。ACS急性期hs-CRP与HbA1c无相关性，HbA1c与动脉粥样硬化斑块慢性进展、累及范围相关，hs-CRP更多反映动脉粥样斑块的不稳定状态。

Objective To explore the correlation between high sensitivity C-reactive protein（hs-CRP） and glycated hemoglobin AI c（ HbA1c） in adult with acute coronary syndrome（ACS）. Methods Coronary artery angiography（CAG） was done for all the subjects by Judkins＇methods; 80 ACS patients were performed. The con- trol group consisted of 32 subjects without CHD, including 6 diabetes. According to the severity of coronary artery stenosis, 80 ACS patients were divided into three groups： single-artery lesions,double-artery lesions and muhi-artery lesions; according to the type of ACS, 80 patients were dinvided into unstable angina pectoris（UA） and acute myocardial infraction（AMI）. The serum content of hs-CRP was measured by enhanced immunoturbidimetric assary （ITM）. HbAlc was measured by liquid chromatography（LC） method. Results hs-CRP levels in all obsercation groups were significantly higher than those in the control group [ （7.85± 5.89 ）, （4.49 ± 2.68 ）, （ 8.79± 5.09 ）, （9.37 ± 5.49 ）, （ 10.93 ± 4.56）, （4.89±2, 09） mg/L vs （ 1.56 ± 1.03 ） rag/L, all P 〈 0.01]. HbAI c levels had no statistical significant difference compared with the control group [ （ 6.48 ± 1. 32 ） % , （ 6.33 ± 1.60 ） % , （6.54±1.68）%,（6.79±1.32）%,（6.49±1.46）%,（6.52 el.32）% vs （6.32±1.20）%,all P〉0.05]. hs-CRP were positively correlated with the lesion counts and the lesion types （ r = 0. 63, r = 0. 74, P 〈 0.01 ）. HbAle had no correlation with lesion counts and the lesion types （ r = 0. 09, r= 0. 09, P 〉 0. 05 ）. Conclusions In the coronary syndrome patients, the concentration of the hs-CRP increased and it is positively correlated with the unstable states of atherosclerotic plaque. But HbAlc has no correlation with unstable coronary atheroselerotic plaque, hs-CRP levels are not correlated with HbA1c＇s. HbA1 c reflect chronic pathological process of atherosclerotic, but hs-CRP can be used as a factor detecting the unstable states of atherosclerotic plaque.