冠状动脉粥样硬化性心脏病患者糖化血红蛋白、脂蛋白-a与冠状动脉病变程度的关系

Correlations of lipoprotein-a,hemoglobin A1c between severity of coronary artery lesion in patients with coronary heart disease

目的探讨冠状动脉(冠脉)粥样硬化性心脏病(冠心病)患者糖化血红蛋白(hemoglobin A1c,HbA1c)、脂蛋白-a(lipoprotein-a,Lp-a)与冠脉病变程度之间的相关性。方法按随机数字表法随机选取2012年3月至2014年9月在荆州医院治疗的冠心病患者226例,记录入选冠心病患者的肝功能、血脂、心电图等相关检测结果及住址、性别、年龄等一般特征资料。测定血清Lp-a、HbA1c浓度,并进行Kruskal-Wallis检验,探究其与冠脉病变程度之间的相关性。结果对4组不同血清Lp-a浓度患者之间的冠脉Gensini评分进行Kruskal-Wallis检验,结果显示差异有统计学意义(P=0.039,χ~2=9.35)。对4组不同血清HbA1c浓度患者之间的冠脉Gensini评分进行Kruskal-Wallis检验,结果显示差异有统计学意义(P=0.029,χ~2=10.58)。Spearman相关性分析结果显示,冠脉Gensini评分与Lp-a呈正相关(r=0.069,P=0.04);冠脉Gensini评分与HbA1c呈正相关(r=0.079,P=0.032);HbA1c与Lp-a无相关性(r=0.031,P=0.23)。结论冠心病患者血清Lp-a浓度、HbA1c浓度与冠脉病变程度呈正相关。

Objectives To explore the relationships of hemoglobin A1c（HbA1c）,lipoprotein-a（Lp-a）and coronaryartery lesion severity in patients with coronary heart disease（CHD）. Methods Totally 226 patients with CHD wererandomly selected from March 2012 to September 2014 in Jingzhou Hospital. Hepatic function,blood lipids,electrocardiogram and relevant test results and general characteristics data,such as the living address,gender,agewere recorded. Serum concentrations of Lp-a and HbA1c were determinated and analyzed by Kruskal Wallis inspection.Results Kruskal Wallis inspection indicated that there were significant differences of coronary Gensini score amongthe 4 different serum concentration of Lp-a groups（P=0.039,χ^2=9.35）and the 4 different serum concentration of HbA1c groups（P=0.029,χ^2=10.58）. Spearman correlation analysis indicated that coronary Gensini score positivelycorrelated with serum concentration of Lp-a（r=-0.069,P=0.04）,positively correlated with serum concentrationof HbA1c（r=0.079,P=0.032）;and HbA1c had no correlation with Lp-a（r=0.031,P=0.23）. Conclusions Serumconcentrations of Lp-a,HbA1c positively correlate with the severity of coronary artery lesions in patients with CHD.