冠心病患者胱抑素C及糖化血红蛋白水平与冠脉病变的关系

Correlations between the level of inhibition C, glycosylated hemoglobin A1c and the coronary lesions in patients with coronary heart disease

目的:探讨血清胱抑素C(Cys-C)、糖化血红蛋白(Hb A1c)与冠脉病变的关系。方法:根据冠脉造影结果分为冠心病组(113例)和对照组(71例),分析Cys-C、Hb A1c水平与冠脉病变程度Gensini积分、病变支数的关系。结果:冠心病组Cys-C、Hb A1c水平高于对照组(P<0.05)。Cys-C及Hb A1c水平与Gensini积分呈正相关(r=0.452,0.570;P<0.05);Cys-C及Hb A1c水平与病变支数呈正相关(P<0.001)。Hb A1c、Cys-C与Gensini积分存在回归关系(β=0.221,t=2.516,P<0.013;β=0.525,t=6.342,P<0.001)。A组(Hb A1c≤6.5%)Cys-C水平与Gensini积分无相关性(r=0.102,P=0.418),B组(Hb A1c>6.5%)Cys-C水平与Gensini积分呈正相关性(r=0.440,P=0.002)。结论:Hb A1c、Cys-C水平与冠脉病变的程度及支数呈正相关,联合检测Cys-C、Hb A1c水平对冠脉病变有一定的预测价值。

Objective To study the correlations between the levels of inhibition C （Cys-C）, glycosylated hemoglobin Alc （HbAlc） and the coronary lesion. Methods 184 patients were divided into the coronary heart disease （CHD） group （n = 113） and the control group （n = 71） according to coronary angiograpby. The correlations between the level of Cys-C, HbAlc and Gensini score and coronary vessel lesions were investigated. Results The levels of Cys-C and HbAlc of CHD group were significantly higher than the control group （P 〈 0.05）. The levels of Cys-C and HbAlc were positively correlated with Gensini score （r = 0.452, 0.570; P 〈 0.05）. The levels of Cys-C and HbAle were positively correlated with coronary vessel lesions （P 〈 0.001 ）. Multivariate analysis showed Cys-C and HbAle were significantly associated with Gensini score （β = 0.221, t = 2.516, P 〈 0.013; = 0.525, t = 6.342, P 〈 0.001）. There was no significant correlation between the level of Cys-C and Gensini score in the subgroup A （r = 0.102, P = 0.418）, and the level of Cys-C was positively correlated with Gensini score in the subgroup B （r = 0.440, P 〈 0.002）. Conclusions The levels of Cys-C and HbAlc are independently associated with the severity and the vessels of the coronary stenosis. Clinically, the joint detections of the levels of Cys-C and HbAlc are a higher predictive value for coronary artery lesions.