急性冠脉综合征患者负荷后两小时血糖与冠状动脉病变程度的相关性研究  

Relationship Study Between Post Challenge Glucose Level and the Severity of Coronary Artery Lesion in Patients With Acute Coronary Syndrome

作　　者：李秋[1] 胡咏梅[1] 刘雅[1] 赵思勤[1] 聂晓莉[1] 吴涛[1] 刘小蓉[1] 王勉[1] 张文勇[1] 

机构地区：[1]成都市第二人民医院心内科,四川省610017

出　　处：《中国循环杂志》2010年第3期178-180,共3页Chinese Circulation Journal

摘　　要：目的:研究急性冠脉综合征(ACS)患者负荷后2小时血糖和胰岛素抵抗与冠状动脉病变严重程度的关系。方法:入选88例ACS患者,男性60例,女性28例,均行冠状动脉造影检查。病情平稳后行75g葡萄糖负荷试验和胰岛素释放试验,分为血糖正常组(n=28)、糖调节异常组(n=37)、糖尿病组(n=23),比较各组冠状动脉病变积分,并分析冠状动脉积分与负荷后2小时血糖水平、胰岛素抵抗的相关性。结果:①血糖正常组、糖调节异常组和糖尿病组冠状动脉积分,差异有统计学意义(P<0.01)。与血糖正常组比,糖调节异常组和糖尿病组空腹胰岛素水平均升高(P<0.01)。②88例患者冠状动脉积分与负荷后2小时血糖呈正相关(r=0.486,P<0.01),与空腹血糖呈正相关(r=0.308,P<0.01)。冠状动脉积分与胰岛素抵抗指数呈正相关(r=0.217,P<0.05)。多元线性回归分析显示负荷后2小时血糖和负荷后2小时胰岛素水平与冠状动脉积分呈正相关(偏相关系数分别为1.392,0.073,P<0.01)。结论:ACS患者负荷后2小时血糖与ACS患者冠状动脉粥样硬化程度有关,餐后血糖越高冠状动脉损害越明显,胰岛素抵抗是其共同的基础。Objective：To evaluate the relationship between post challenge glucose level and the severity of coronary artery lesions in patients with acute coronary syndrome （ACS）. Methods ： A total of 88 patients including 60 male and 28 female with ACS were diagnosed by coronary angiography. According to oral glucose tolerance test （OGTF）, the patients were divided into three groups as Euglycemia group （n = 28 ）, Impaired glucose tolerance group （n = 37 ） and Diabetes group（ n=23 ）. Correlations between coronary lesion score, post challenge of 2-hour glucose level and insulin resistance （IR） were studied in all groups. Results ： （ 1 ） The coronary lesion scores showed the statistical meaning in different groups （ P 〈 0. 01 ）. Compared with Euglycemia group, IR was increased in hnpaired glucose tolerance group and Diabetes group （P 〈 0. 01 ）, respectively. （2）Coronary lesion score was correlated with post challenge of 2-hour glucose level or fasting blood glucose （ r = 0. 486, P 〈 0. 01 ; r = 0. 308, P 〈 0. 01 ）, and coronary lesion score was also related to IR（ P 〈 0.05 ）. Multiple linear regression indicated that only post challenge of 2-hour glucose level and 2-hour insulin level were independently correlated with the severity of coronary lesions （β = 1. 392, 0. 073 ,respectively,P 〈0. 01 ）. Conclusion ：The severity of coronary lesions was significantly related with post challenge of 2-hour glucose level in patients with ACS. IR might be one of the fundamental mechanism factors.

关 键 词：冠脉综合征 负荷后血糖 胰岛素抵抗 

分 类 号：R54[医药卫生—心血管疾病]