2型糖尿病合并急性冠状动脉综合征hs-CRP、IL-6和HbA_(1c)的变化及相关性

Correlation among the levels of hs-CRP,IL-6,HbA_(1c) and type 2 diabetes mellitus complicated with acute coronary syndrome

目的探讨2型糖尿病(DM)合并急性冠状动脉综合征(ACS)患者外周血炎性因子hs-CRP、IL-6和HbA_(1c)的变化及相关性。方法 2014年1—11月诊治2型DM合并ACS患者64例为观察组,另选择单纯2型DM患者56例为对照组,比较分析2组患者hs-CRP、IL-6和HbA_(1c)水平的差异,并分析炎性因子和HbA_(1c)与冠状动脉狭窄程度间的关系。结果观察组hs-CRP、IL-6和HbA_(1c)水平患者均高于对照组(t=2.562、2.382、2.809,P均<0.05),三者的阳性率观察组高于对照组(X^2=2.653、P=0.037,X^2=3.592、P<0.01,X^2=3.221、P<0.01)。患者血清hsCRP、IL-6、HbA_(1c)水平随冠状动脉病变支数增加逐步升高(F=2.825、P=0.039,F=3.025、P=0.019,F=2.938、P=0.027)。冠状动脉病变程度与血清hs-CRP、IL-6和HbA_(1c)水平变化呈正相关(r=0.421、P=0.036,r=0.382、P=0.032,r=0.576、P=0.024)。结论糖尿病合并冠心病患者血清hs-CRP、IL-6活性均不同程度增高,炎性因子和HbA_(1c)可能在糖尿病的发生及糖尿病诱发冠心病的发生、发展过程中起重要作用。

Objective To investigate the changes of peripheral blood inflammatory factors of hs-CRP,IL-6 and HbA1c and correlation with type 2 diabetes mellitus（DM） complicated with acute coronary syndrome（ACS）.Methods From January 2014 to November 2014,64 patients with type 2 DM and ACS were enrolled as observation group,the other 56 cases of simple type 2 DM patients were enrolled as control group,compared the differences of hs-CRP,IL-6 and HbA,,.between the2 groups,and analyzed the relationship between inflammatory factors,HbA1c and coronary stenosis degree.Results The levels of hs-CRP,IL-6 and HbA,,.in observation group were higher than those in control group（t =2.562,2.382,2.809,P <0.05）,the positive rate of the observation group is higher than those of control group（x2 =2.653,P =0.037,x2 =3.592,P < 0.01,x2 =3.221,P < 0.01）.The levels of serum hs-CRP,IL-6,HbA,,.were gradually increased with the branch amount of coronary artery stenosis increased（F = 2.825,P = 0.039,F = 3.025,P = 0.019,F = 2.938,P = 0.027）.There were positive correlation between the severity of coronary lesion and serum hs-CRP,IL-6 and HbA,,.（r =0.421,P =0.036,r =0.382,P =0.032,r =0.576,P =0.024）.Conclusion Serum hs-CRP,IL-6’s activity were increased in patients with diabetes combined coronary heart disease,inflammatory factor and HbA1c play a significant role in the occurrence of diabetes and development process of diabetes induced coronary heart disease.