冠心病合并糖尿病患者的血脂水平观察及临床意义研究

Observation of blood lipid levels in patients with coronary heart disease and diabetes mellitus and study its clinical significance

目的观察冠状动脉粥样硬化性心脏病(冠心病,CAD)合并糖尿病(DM)患者的血脂水平,并分析其临床意义。方法100例CAD患者,根据是否合并DM分为单纯CAD组和CAD合并DM组,每组50例。比较两组患者血脂指标[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、甘油三酯(TG)]、血糖指标(空腹血糖)、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)]和心功能指标[左房内径(LAD)、右房内径(RAD)、左室射血分数(LVEF)];分析CAD合并DM患者血脂指标与血糖指标、炎症因子、心功能指标的相关性。结果CAD合并DM组患者的TC(5.88±1.35)mmol/L、LDL-C(2.45±0.63)mmol/L、TG(1.38±0.32)mmol/L、空腹血糖(6.98±1.34)mmol/L高于单纯CAD组患者的(4.01±1.02)、(1.83±0.34)、(0.99±0.13)、(4.71±1.02)mmol/L,HDL-C(1.08±0.27)mmol/L低于单纯CAD组患者的(1.41±0.59)mmol/L,差异具有统计学意义(P<0.05)。CAD合并DM组患者的TNF-α(28.45±4.02)ng/L、IL-1β(11.53±2.07)pg/ml高于单纯CAD组患者的(10.38±3.15)ng/L、(5.42±0.98)pg/ml,差异具有统计学意义(P<0.05)。CAD合并DM组患者的LAD(30.92±3.11)mm、RAD(28.10±3.24)mm长于单纯CAD组患者的(22.45±2.04)、(20.12±2.15)mm,LVEF(52.02±3.46)%低于单纯CAD组患者的(58.34±3.01)%,差异具有统计学意义(P<0.05)。CAD合并DM患者的TC、LDL-C、TG水平与TNF-α、IL-1β水平呈正相关(P<0.05),HDL-C与TNF-α、IL-1β水平呈负相关(P<0.05)。结论CAD合并DM患者的TC、LDL-C、TG水平较高,HDL-C水平较低,且与患者炎症因子TNF-α、IL-1β水平相关。

Objective To observe the blood lipid levels in patients with coronary heart disease(CAD) and diabetes mellitus(DM)and analyze its clinical significance.Methods A total of 100 patients with CAD were divided into simple CAD group and CAD combined DM group according to whether they were combined with DM,with 50 cases in each group.Both groups were compared in terms of blood lipid indexes[total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C),triglyceride(TG)],blood glucose indexes(fasting blood glucose),inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)]and cardiac function indicators[left atrial diameter(LAD),right atrial diameter(RAD),left ventricular ejection fraction(LVEF)].The correlation of blood lipid indexes with blood glucose indexes,inflammatory factors and cardiac function indexes in patients with CAD complicated with DM was analyzed.Results The TC(5.88±1.35)mmol/L,LDL-C(2.45±0.63)mmol/L,TG(1.38±0.32)mmol/L,fasting blood glucose(6.98±1.34)mmol/L in CAD combined DM group were higher than(4.01±1.02),(1.83±0.34),(0.99±0.13),(4.71±1.02)mmol/L in simple CAD group;the HDL-C(1.08±0.27)mmol/L in CAD combined DM group was lower than(1.41±0.59)mmol/L in simple CAD group;all the differences were statistically significant(P<0.05).The TNF-α(28.45±4.02)ng/L and IL-1β(11.53±2.07)pg/ml in CAD combined DM group were higher than(10.38±3.15)ng/L and(5.42±0.98)pg/ml in simple CAD group,and the differences were statistically significant(P<0.05).The LAD(30.92±3.11)mm and RAD(28.10±3.24)mm in CAD combined DM group were longer than(22.45±2.04)and(20.12±2.15)mm in simple CAD group;the LVEF(52.02±3.46)%in CAD combined DM group was lower than(58.34±3.01)%in simple CAD group;all the differences were statistically significant(P<0.05).The TC,LDL-C and TG levels were positively correlated with TNF-αand IL-1βlevels(P<0.05),and HDL-C was negatively correlated with TNF-αand IL-1βlevels in patients with CAD combined with DM(P<0.05).Conclusion The levels of TC,LDL-C and TG in patients with CAD combined with DM were higher,and the level of HDL-C was lower,and they were related to the levels of inflammatory factors TNF-αand IL-1β.