糖化血红蛋白和内皮素变化与冠状动脉粥样硬化的关系

Correlation between coronary artery disease and levels of glycosylated hemoglobin and endothelin

目的探讨糖化血红蛋白(HbA1c)和内皮素(ET)水平与冠状动脉粥样硬化之间的关系及其测定的临床意义。方法连续入选住院患者572例,根据血糖水平和冠状动脉造影结果将研究对象分为4组:阴性对照组40例、单纯糖尿病(DM)组50例、单纯冠心病(CHD)组262例、DM合并CHD组220例。比较4组之间HbA1c水平及ET水平的差异,并通过Logistic回归分析,探讨其与冠状动脉粥样硬化的关系。结果 HbA1c水平:对照组、单纯CHD组<单纯DM组<DM合并CHD组,对照组与单纯CHD组比较,差异无统计学意义(P>0.05);ET水平:对照组<单纯CHD组、单纯DM组<DM合并CHD组,单纯CHD与单纯DM组比较,差异无统计学意义(P>0.05)。ET为CHD发病独立危险因素,而HbA1c与CHD发病无明显相关。结论ET较HbA1c与CHD有更好的相关性,但DM患者会对结果判定造成偏倚,综合检测HbA1c与ET,有利于CHD合并DM更准确的诊断。

Objective To analysis the correlation between coronary atherosclerosis and levels of glycated hemoglobin （HbA1c） and endothelin（ET ） ,furthermore to explore the clinical significance of the two indexes in the department of cardiology .Methods 572 inpatients were divided into four groups according to the blood glucose level and coronary angiography results ：negative control group with 40 patients ,simplex DM group with 50 patients ,simplex CHD group with 262 patients ,CHD＋DM group with 220 pa-tients .The HbA1c and ET levels in the four groups were monitored ,and the correlations between the two indexes and coronary ath-erosclerosis were analysed by Logistic regression analyses .Results HbA1c level ：control group and CHD group 〈 DM group〈CHD＋DM group .No significant differences were observed between control group and CHD group （P〉 0 .05） .ET level ：control group 〈 CHD group and DM group 〈 CHD＋DM group .No significant differences were observed between CHD group and DM group（P〉0 .05） .After adjusted the potential risk factors such as age ,sex ,body mass index ,smoking ,the history of hypertension and blood glucose levels with binomial Logistic regression analysis the content of ET was relevant to the onset of CHD ,however HbA1c not .Conclusion ET has obviously correlation with coronary atherosclerosis ,however the simplex DM may cause false posi-tive interferences .Combined determination of HbA1c and ET is beneficial in the preliminary diagnosis of CHD and DM .