冠心病合并2型糖尿病患者血清亲环素A水平与冠状动脉病变程度的相关性

Correlation between serum cyclophilin A level and degree of coronary artery disease in coronary heart disease patients with type 2 diabetes mellitus

目的探讨冠心病(CHD)合并2型糖尿病(T2DM)患者血清亲环素A(CyPA)水平与冠状动脉(冠脉)病变严重程度的相关性。方法250例老年人根据冠脉造影检查结果及血糖水平分为正常对照组(50例)、单纯CHD组(100例)和CHD合并T2DM(CHD+T2DM)组(100例)。单纯CHD组进一步分为单纯稳定型心绞痛(SAP)组(50例)和单纯急性冠脉综合征(ACS)组(50例);CHD+T2DM组进一步分为SAP合并T2DM(SAP+T2DM)组(50例)和ACS合并T2DM(ACS+T2DM)组(50例)。比较各组患者临床和血清生化指标以及冠脉Gensini评分,分析CHD+T2DM组和单纯CHD组血清CyPA水平与冠脉病变程度的相关性。结果SAP+T2DM组和ACS+T2DM组年龄、高血压病患者比例、FBG、HbA1c水平高于单纯SAP组、单纯ACS组和正常对照组(P<0.05)。SAP+T2DM组血清CyPA水平和Gensini评分高于单纯SAP组和正常对照组(P<0.05),ACS+T2DM组血清CyPA水平和Gensini评分高于单纯ACS组和正常对照组(P<0.05)。Spearman相关分析显示,CHD+T2DM组和单纯CHD组血清CyPA水平与Gensini评分均呈正相关(r_(s)=0.860和0.187,P<0.01)。CHD患者中,冠脉多支病变组血清CyPA和HbA1c水平高于双支病变组和单支病变组(P<0.05)。ACS患者血清CyPA和HbA1c水平高于SAP患者(P<0.05)。结论CHD合并T2DM患者血清CyPA水平与冠脉病变严重程度密切相关,CyPA联合HbA1c可作为诊断ACS的有效标志物。

Objective To investigate the correlation between serum cyclophilin A(CyPA)level and the degree of coronary artery disease in coronary heart disease(CHD)patients with type 2 diabetes mellitus(T2DM).Methods According to the results of coronary angiography and blood glucose level,250 elderly people were divided into three groups of C(healthy people as the controls,50 cases),CHD(100 cases)and CHD+T2DM(CHD combined with T2DM,100 cases).Group CHD was further divided into two groups of SAP(with stable angina pectoris,50 cases)and ACS(with acute coronary syndrome,50 cases).Group CHD+T2DM was further divided into two groups of SAP+T2DM(with SAP combined with T2DM,50 cases)and ACS+T2DM(with ACS combined with T2DM,50 cases).The clinical and serum biochemical indexes and Gensini score were compared among the groups.The correlation between serum CyPA level and the degree of coronary artery disease in groups of CHD+T2DM and CHD was analyzed.Results The age,proportion of hypertensive patients,FBG and HbAlc levels in groups of SAP+T2DM and ACS+T2DM were higher than those in groups of SAP,ACS and C(P<0.05).Serum CyPA level and Gensini score in group SAP+T2DM were higher than those in groups of SAP and C(P<0.05),which in group ACS+T2DM were higher than those in groups of ACS and C(P<0.05).Spearman correlation analysis showed a positive correlation between serum CyPA level and Gensini score in groups of CHD+T2DM and CHD(r_(s)=0.860 and 0.187,P<0.01).Serum levels of CyPA and HbAlc in CHD patients with multi vessel disease were higher than those in patients with dual vessel disease and single vessel disease(P<0.05),which in ACS patients were higher than those in SAP patients(P<0.05).Conclusion Serum CyPA level in CHD patients with T2DM is closely related to the severity of coronary artery disease.CyPA combined with HbAlc may be an effective serum marker for diagnosing ACS.