糖化血红蛋白在非糖尿病冠心病诊断中的临床应用价值

Clinical value of glycosylated hemoglobin in diagnosis of non diabetic coronary heart disease

目的探讨糖化血红蛋白(HbA_(1c))水平在非糖尿病冠心病(CHD)患者中变化及临床应用价值。方法收集58例冠心病患者为研究对象,分为不稳定型心绞痛(UAP)组22例、非ST段抬高型心肌梗死(NSTEMI)组20例及ST段抬高型心肌梗死(STEMI)组16例,另选择健康体检者32例为健康对照组,检测血浆HbA_(1c)水平筛选非糖尿病CHD相关临床生化指标。结果 UAP组患者HbA_(1c)水平明显低于STEMI组,差异有统计学意义(U=99.5,P<0.05);当HbA_(1c)>6.5%,非糖尿病CHD发生率为92.7%;多参数Logistic回归分析结果显示,高血压、HbA_(1c)是影响非糖尿病急性冠状动脉综合征主要危险因素。结论 HbA_(1c)在非糖尿病CHD患者水平显著增高,是CHD的独立危险因素,与其病变程度呈正相关。临床医生在诊断CHD疾病时,应重视对非糖尿病患者HbA_(1c)的检测。

Objective To investigate the glycosylated hemoglobin（ HbA_（1c）） levels in non diabetic coronary heart disease（ CHD）patients change and clinical application value. Methods 58 patients with coronary heart disease were collected and divided into the unstable angina pectoris（ UAP） group（ 22 cases）,non ST elevation myocardial infarction（ NSTEMI） group（ 20 cases） and ST segment elevation myocardial infarction（ STEMI） group（ 16 patients）,and 32 healthy controls were selected as the control group.All the subjects were conducted for the detection of HbA_（1c） level in plasma and the screening of non diabetes CHD related clinical and biochemical indexes. Results The levels of HbA_（1c）in the UAP group was significantly lower than that of STEMI group,and the difference was statistically significant（ U = 99. 5,P〈 0. 05）; when HbA_（1c）was less than 6. 5%,the incidence rate of non diabetes CHD was 92. 7%; Logistic regression analysis showed that hypertension,HbA_（1c）were the main risk factors of affecting the non diabetic patients with acute coronary syndrome. Conclusion The level of HbA_（1c）was significantly higher in non-diabetic CHD patients,and also an independent risk factor for CHD,and positively correlated with the degree of pathological changes.Clinicians should pay attention to the detection of HbA_（1c）in non-diabetic patients when diagnosing CHD disease.