血清胆红素、糖化血红蛋白与血脂联合检验在2型糖尿病合并冠心病患者诊断中的意义

Significance of combined test of serum bilirubin, glycosylated hemoglobin and blood lipids in the diagnosis of type 2 diabetes mellitus with coronary heart disease

目的探讨血清胆红素(TBil)、糖化血红蛋白(HbA1c)和血脂联合检验在2型糖尿病合并冠心病患者诊断中的应用价值。方法选取2016年5月至2017年5月来我院就诊的150例2型糖尿病患者作为研究对象,根据有无合并冠心病将其分为观察组和对照组,每组75例。观察组为合并冠心病患者,对照组为未合并冠心病患者。比较两组患者的TBil、HbA1c、HDL-C、LDL-C、TC及TG水平;观察组采用Gensini评分,分析各血清学指标与冠状动脉病变程度的相关性。结果观察组TBil、HDL-C水平低于对照组,HbA1c、TC、TG、和LDL-C水平均高于对照组,差异具有统计学意义(P<0.05)。Spearman相关分析显示,观察组TBil和HDL-C水平与CSS评分呈负相关,HbA1c、TC、TG和LDL-C水平与CSS评分呈正相关(P<0.05)。结论2型糖尿病患者TBil、HbA1c和血脂的变化与冠心病及冠状动脉病变程度密切相关,TBil、HbA1c及血脂联合检验在2型糖尿病合并冠心病的检测中具有重要的指导意义,可以为临床医师的诊断和治疗提供科学依据。

Objective To explore the application value of combined test of serum bilirubin(TBil),glycosylated hemoglobin(HbA1c)and blood lipids in the diagnosis of type 2 diabetes mellitus with coronary heart disease.Methods A total of 150 patients with type 2 diabetes mellitus who treated in our hospital from May 2016 to May 2017 were selected as the study objects.According to whether there was coronary heart disease,the patients were divided into observation group and control group,with 75 cases in each group.The patients with coronary heart disease were seted as the observation group,and the patients without coronary heart disease were seted as the control group.The levels of TBil,HbA1c,HDL-C,LDL-C,TC and TG were compared between the two groups,and the correlation between the serum indexes and the degree of coronary artery disease were analyzed by Gensini score in the observation group.Results The levels of TBil and HDL-C in the observation group were lower than those in the control group,and the levels of HbA1c,TC,TG and LDL-C in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Spearman correlation analysis showed that in the observation group,the levels of TBiL and HDL-C were negatively correlated with CSS score,the levels of HbA1c,TC,TG and LDL-C were positively correlated with CSS score(P<0.05).Conclusion The changes of TBiL,HbA1c and blood lipid in type 2 diabetic patients are closely related to coronary heart disease and the degree of coronary artery disease.The combined test of TBil,HbA1c and blood lipid has important guiding significance in the detection of type 2 diabetes mellitus with coronary heart disease,which can provide scientific basis for the diagnosis and treatment of clinicians.