急性冠脉综合征合并2型糖尿病的临床特点及血清超敏C反应蛋白检测的意义  

Clinical Feature of Acute Coronary Syndrome with Type 2 Diabetes Mellitus and Significance of Detecting C-Reactive Protein

作　　者：黄丽娟[1] 李向平[1] 肖阳[1] 许晶晶[1] 

机构地区：[1]中南大学湘雅二医院心内科,湖南省长沙市本科进修医师410011

出　　处：《中国全科医学》2010年第27期3015-3017,3020,共4页Chinese General Practice

摘　　要：目的探讨急性冠脉综合征(ACS)合并2型糖尿病的临床特点及血清超敏C反应蛋白(hs-CRP)检测的临床意义。方法回顾性分析140例ACS男性患者的病历资料,其中合并2型糖尿病者(DM组)60例,未合并糖尿病者(NDM组)80例。分析比较两组患者的一般资料、血生化指标、冠状动脉造影结果,并对hs-CRP的相关因素进行分析。结果与NDM组相比,DM组血清三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B(ApoB)、尿素氮(BUN)、肌酐(Cr)、尿酸(UA)、hs-CRP水平显著高于NDM组,差异有统计学意义(P<0.05)。冠脉造影发现DM组多支血管病变及左主干病变的发生率显著高于NDM组,差异有统计学意义(P<0.05)。直线相关分析表明,hs-CRP水平与空腹及早餐后2h血糖、TG、TC、LDL-C、ApoB、冠状动脉病变严重程度呈正相关(P<0.05);与HDL-C、ApoA1呈负相关(P<0.05)。结论 ACS合并2型糖尿病患者代谢异常更明显,体内的炎症反应更活跃,冠状动脉受累更为严重,hs-CRP水平可作为反映病情严重程度的参考指标。Objective To investigate the clinical feature of acute coronary syndrome （ACS） with type 2 diabetes mellitus （DM） and the significance of detecting serum high sensitive-C reactive protein （hs-CRP） level.Methods The clinical data of totally 140 patients with ACS were retrospectively collected,in which 60 patients complicated with DM （DM group） and 80 patients did not with DM （control group）.The clinical history,blood biochemistry index and coronary angiography results in the two groupes were compared.The correlation between hs-CRP and other variables was analyzed.Results Compared with the control group,the serum levels of triglyceride （TG）,Low density lipoprotein-cholesterol （LDL-C）,apolipoprotein-B （ApoB）,blood urea nitrogen （BUN）,creatinine （Cr） and uric acid （UA） in DM group were higher （allP0.05） and the level of hs-CRP was significantly increased （P0.01）.There were higher incidence of multivessel disease and left main coronary artery stenosis in the DM group than those in the control group by coronary angiography （allP0.05）.Pearson correlation analysis showed that the hs-CRP level had a positive correlation with fast and 2-hour post-prandial blood glucose,TG,total cholesterol,LDL-C and the severity of coronary artery disease （allP0.05） and had a negative correlation with high density lipoprotein-cholesterol,and apolipoprotein-AI （allP0.05）.Conclusion There were more pronounced metabolic disturbance,more intense inflammatory response and more severe involvements of coronary arteries in ACS patients with DM.The level of hs-CRP may be a useful index which can reflect the severity of the disease.

关 键 词：冠状动脉疾病 糖尿病 C反应蛋白 男性 

分 类 号：R541[医药卫生—心血管疾病]