摘要
目的 探讨糖化血红蛋白（HbA1c）能否作为非糖尿病急性冠脉综合征（ACS）患者冠脉病变情况及病情评估的一个指标.方法 选择非糖尿病的ACS患者60例,测定其血清HbA1c水平,同时测定随机血糖、空腹血糖、高敏C反应蛋白（hs-CRP）、肌钙蛋白、肌酸激酶同工酶（CK-MB）、低密度脂蛋白胆固醇（LDL-C）,并行选择性左右冠状动脉造影.结果 非糖尿病的ACS患者血清HbA1c水平明显高于稳定型心绞痛组和非冠心病组患者（P＜0.01）,且与hs-CRP呈显著正相关（rs=0.725,P=0.002）;与随机血糖及空腹血糖呈显著正相关（rs=0.665,P=0.007）;与LDL-C有较弱相关性（rs=0.535,P=0.49）,但差异无统计学意义.HbA1c水平与肌钙蛋白I（rs=0.41,P=0.129）、CK-MB（rs=0.415,P=0.124）没有相关性.HbA1c水平和冠脉病变支数呈明显正相关（rs=0.813,P=0.006）;与Jenkins积分呈正相关（rs=0.745,P=0.022）.结论 HbA1c可反映非糖尿病ACS患者病情严重程度,可作为心血管事件高发及预后不良的一个评估指标.
Objective To investigate the clinical value of glycosylated hemoglobin（ HbAlc ） in nondiabet- ic patients with acute coronary syndrome. Methods This observational study included consecutive patients（n=60） without known diabetes mellitus admitted with acute coronary syndrome. Both admission glucose and troponin I, CK-MB were measured on admission. The serum HbAlc, fasting plasma glucose, hs-CRP and LDL-C were measured in the next day, and the coronary angiography （CAG） was performed in all patients. Results In nondia- betic patients with ACS, circulating HbAlc levels were significantly higher than that in patients with stable angina and non-CHD（P〈0.01 ）, HbAlc levels correlated obviously with levels of hs-CRP（rs=0.725, P=0.002）, admis- sion glucose and fasting plasma glucose（r,=0.665, P=0.007）, but not with markers of myocardial injury（troponin I and CK-MB）, there was obviously correlation between the levels of serum HbAlc and Jenkins score（r~=0.745, P= 0.022）, the number of stenosis vessels（r,=0.813, P=0.006）. Conclusion Circulating HbA1c levels are elevate in nondiabetic patients with ACS and correlate with hs-CRP, glucose, LDL-C, the number of stenosis vessels and degree of coronary artery stennsis but not correlate with troponin I, CK-MB, HbA1c can contribute to a comprehensive understanding of the severity of the ACS and guide clinical treatment and the preliminary judgement of complications and prognosis.
出处
《中国心血管病研究》
CAS
2014年第11期1022-1025,共4页
Chinese Journal of Cardiovascular Research
