糖耐量受损急性冠脉综合征患者血清同型半胱氨酸、C反应蛋白水平的研究  

The Study of Serum Homocysteine and C-reactive Protein Levels in Acute Coronary Syndrome Patients with Impaired Glucose Tolerance

作　　者：张春蕾[1] 崔燕[1] 杨辉[1] 

机构地区：[1]吉林大学第二医院心血管内科,吉林长春130041

出　　处：《中国实验诊断学》2012年第10期1826-1829,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨同型半胱氨酸、C反应蛋白在不同糖耐量的急性冠脉综合征(ACS)患者血清中的变化及其相关性,以探讨急性冠脉综合征在合并糖耐量受损情况下,促发动脉粥样硬化斑块破裂,引发临床事件的可能机制,为及时、有效地干预糖耐量受损患者急性冠脉事件提供新的评价指标。方法选择急性冠脉综合征(ACS)患者89例,根据不同糖耐量水平分为:对照组-糖耐量正常组(NGT组)(29例);2型糖尿病组(T2DM组)(30例);糖耐量受损组(IGT组)(30例)。分别检测血清中同型半胱氨酸、C反应蛋白水平。结果①与NGT组相比,伴IGT组和T2DM组的ACS患者HCY、CRP显著升高,P<0.05。②T2DM组血清HCY、CRP水平高于IGT组,但无统计学意义(P<0.05);③HCY、CRP与HOMA-IR存在正相关(r值分别是0.328、0.362,P<0.05),HCY、CRP之间存在正相关(r值是0.276,P<0.05)。结论①2型糖尿病与糖耐量受损的ACS患者较糖耐量正常的ACS患者具有更明显的炎症反应。②胰岛素抵抗是引起斑块不稳定性增加的因素之一。③HCY、CRP在ACS合并胰岛素抵抗时呈正相关,共同促进糖耐量受损患者ACS的发生。Objective To investigate the change and relationship of serum homocysteine（HCY） and c-reactive protein（CRP） levels in acute coronary syndrome（ACS） patient with impaired glucose tolerance（IGT）.Methods the levels of HCY and CRP in 89 ACS patients were determined.And the patients were divided into three groups by different glucose tolerance.They are NGT group,IGT group and T2DM group.Results ①Compared with NGT group the levels of HCY and CRP in ACS patients with IGT group and T2DM group were significantly higher.②Although the levels of HCY and CRP in T2DM group were higher than the IGT group,but have no statistically difference（P0.05）.③The levels of HCY,CRP and HOMA-IR in ACS patients are closely related.Conclusion ①Inflammation in ACS patient with IGT and T2DM group is more notable than the NGT group.②Insulin resistance is a major factor lead to increase instability of atherosclerosis plaque.③Both HCY and CRP promote the process of ACS.

关 键 词：急性冠脉综合征 同型半胱氨酸 C反应蛋白 2型糖尿病 糖耐量受损 

分 类 号：R541.4[医药卫生—心血管疾病]