糖化血清蛋白水平与冠心病动脉粥样硬化斑块性质的相关性  

Relation of glycated serum album and vulnerable plaque characteristics in patients with CHD

作　　者：祝庆[1,2] 康维强[1,3] 葛志明[4] 宋达琳 王海滨 任国瑞 

机构地区：[1]山东大学医学院,济南250012 [2]青岛海慈医院心内科,山东青岛266033 [3]青岛市老年医学研究所,山东青岛266011 [4]山东大学齐鲁医院心内科,济南250012

出　　处：《山东大学学报（医学版）》2011年第7期100-104,共5页Journal of Shandong University:Health Sciences

摘　　要：目的通过血管内超声-虚拟组织学(IVUS-VH)技术探讨冠心病(CHD)合并糖尿病(DM)患者冠状动脉病变的特点及其与糖化血红蛋白(HbA1c)、糖化血清蛋白(GA)的相关性。方法对53例CHD合并DM患者及49例不合并DM的CHD患者冠状动脉进行IVUS-VH检查,分析两组斑块的性质及其与临床GA、HbA1c水平的相关性。结果 CHD合并DM患者易损斑块发生率显著高于不合并DM的CHD患者(36.7%∶14.5%,P<0.05),斑块组成以纤维脂肪组织和坏死成分为主,而不合并DM的CHD患者斑块纤维成分和钙化成分较高。GA水平与纤维脂肪组织呈正相关(r=0.018,P<0.05),明显优于HbA1c。结论 CHD合并DM患者易损斑块发生率明显高于不合并DM的CHD患者,且斑块成分不同。GA与冠状动脉粥样硬化斑块性质相关。Objective To analyze characteristics of atherosclerotic plaques in coronary heart disease（CHD） patients with diabetic mellitus（DM） by intravascular ultrasound-virtual histology（IVUS-VH） and to discuss their correlations with glycated serum album（GA） and glycated hemoglobin（HbA1c）.Methods In 53 CHD patients with DM and 49 CHD patients,culprit lesions were detected with IVUS-VH to investigate characteristics of atherosclerotic plaques and their relevance with GA and HbA1c.Results CHD patients with DM presented a significantly higher prevalence of vulnerable plaques than CHD patients（6.7%：14.5%,P〈0.05）,with a clear clustering pattern,mainly consisting of fibro-fatty tissues and necrotic core-rich tissues.There were higher levels of fibrous tissues and dense calcium tissues in CHD patients compared with CHD patients with DM.There was a positive relevance of fibro-fatty tissue with GA（r=0.018,P〈0.05）,which was much higher than that with HbA1c.Conclusion As shown by IVUS-VH,the prevalence of vulnerable plaques in CHD patients with DM is much higher than that of CHD patients,coupled with different intra-plaque compositions,which is associated with the GA level.

关 键 词：糖尿病合并冠心病 血管内超声-虚拟组织学 糖化血清蛋白 易损斑块 

分 类 号：R541.4[医药卫生—心血管疾病]