糖尿病合并冠心病患者检测糖化血红蛋白的临床价值

The clinical value in detecting glycosylated hemoglobin in diabetic patients with coronary heart disease

目的探讨血液糖化血红蛋白(Hb A1c)水平与糖尿病合并冠心病的关系及Hb A1c测定的临床意义。方法选择本院内分泌科糖尿病合并冠心病患者200例,均已确诊。根据冠状动脉病变支数分为单支病变组和多支病变组;采用离子交换高压液相色谱法(HPLC)测定血液Hb A1c浓度,统计分析Hb A1c<5.70%、5.70%≤Hb A1c≤6.50%、Hb A1c>6.50%时冠状动脉单支病变和多支病变的阳性率。结果当Hb A1c<6.50%时,糖尿病心血管病变的发生率较低,冠状动脉多支病变阳性率与单支病变阳性率差异无统计学意义(P>0.05);当Hb A1c>6.50%时,糖尿病心血管病变的发生率较高,冠状动脉多支病变阳性率明显高于单支病变阳性率,差异有统计学意义(P<0.05)。结论 Hb A1c与冠心病的发生密切相关。糖尿病患者随着Hb A1c的升高而并发心血管病的机率增大,Hb A1c的水平与冠心病的严重程度呈正相关。

Objective To explore the correlation between blood glycosylated hemoglobin（ Hb A1c） level and diabetes mellitus complicated with coronary heart disease,and the clinical significance of its detection. Methods 200 cases of confirmed patients from department of endocrinology with coronary heart disease and diabetes in our hospital were collected. According to the diseased branch amount of coronary arteries,they were divided into the single vessel group and multiple vessel group. We determined the concentration of serum Hb A1 c by high performance liquid chromatography（ HPLC）,and statistically analyzed the positive rate of single diseased coronary artery and multi- vessel diseased artery at Hb A1 c 〈 5. 70%,5. 70% ≤Hb A1c≤6. 50%.Results When Hb A1 c was less than 6. 50%,diabetic mellitus with cardiovascular disease was at low incidence,the difference between the positive rate of multiple diseased branches and the single diseased branch（ P 〉 0. 05） had no statistical significance. When Hb A1 c was more than 6. 50%,the diabetic cardiovascular disease was at higher incidence,the positive rate of multi- vessel coronary artery was higher than that of the single branch lesions,the difference had statistical significance（ P 〈0. 05）. Conclusion Hb A1 c is closely related to the occurrence of coronary heart disease. Diabetic patients are probable to get cardiovascular disease with increased Hb A1 c,the level of Hb A1 c is related positively with severity of coronary heart disease.