急性冠脉综合征患者糖化血红蛋白测定的意义  

The significance of glycosylated hemoglobin determination among patients with acute coronary syndrome

作　　者：邹洪兴[1] 

机构地区：[1]浙江省嘉兴市第一医院检验科,浙江嘉兴314000

出　　处：《中国卫生检验杂志》2013年第6期1538-1539,共2页Chinese Journal of Health Laboratory Technology

摘　　要：目的:通过检测急性冠脉综合征患者糖化血红蛋白(HbAlc),探讨急性冠脉综合征患者HbA1c检测的临床意义。方法:选择确诊的急性冠脉综合征患者179例,其中根据空腹血糖(FPG)情况分冠脉综合征合并糖尿病组74例、冠脉综合征合并糖耐量异常组37例、单纯冠脉综合征组68,分别行冠脉造影并测定HbAlc,比较各组的冠心病病变程度(Gensini积分)、HbAlc水平以及两者相关性。结果:冠脉综合征合并糖尿病组及冠脉综合征合并糖耐量异常组分别同单纯冠脉综合征组比较,Gensini积分、HbAlc水平明显升高,差异有统计学意义(P<0.01);冠脉综合征合并糖尿病组与冠脉综合征合并糖耐量异常组比较,Gensini积分、HbAlc水平差异有统计学意义(P<0.05);三组间HbAlc与冠脉病变程度相关性较好(r=0.80,P<0.01)。结论:HbAlc是急性冠脉综合征的独立危险因素,急性冠脉综合征入院患者应检测HbAlc,了解血糖代谢情况,有助于全面了解病情严重程度,指导临床治疗和初步判断并发症及预后。Objective： To investigate the clinical significance of glycosylated hemoglobin （HbAlc） testing in patients with acute coronary syndrome. Methods： One hundred and seventy - nine cases diagnosed with acute coronary syndrome were involved in this study. According to the fasting plasma glucose （ FPG）, they were divided into diabeteic group, abnormal glucose metabolism group, simple coronary syndrome group. Then the severity of coronary heart disease （ Gensini score）, glycated hemoglobin levels for each group and both correlation were analyzed and compared. Results： Compared with simple coronary syndrome group, Gensini score and HbAlc level in diabetic group and abnormal glucose metabolism group were significantly higher. The difference was statistically significant （ P 〈 0.01 ） ; Gensini score and HbAlc level in diabetic group were significantly higher than those in abnormal glucose metabolism group（P 〈0.05 ）. Correlation analysis showed the level of glycosylated hemoglobin was positively correlated with severity of coronary disease（ r = 0.80, P 〈 0.01 ）. Conclusion： HbAlc is an independent risk factor for acute coronary syndrome. Patients with acute coronary syndrome should be examined for HbAlc to understand the glucose metabolism, which can contribute to a comprehensive understanding of the severity of the disease and guide clinical treatment and the preliminary judgement of complications and prognosis.

关 键 词：急性冠状动脉综合征 糖化血红蛋白 糖耐量异常 

分 类 号：R51[医药卫生—内科学]