高龄糖尿病合并心房颤动患者高敏C反应蛋白和同型半胱氨酸与颈动脉硬化关系的研究  

Correlation of hs-CRP and Hcy with carotid atherosclerosis in advance-aged diabetic patients with atrial fibrillation

作　　者：卜聪亚[1] 周玉杰[1] 赵迎新[1] 马涵英[1] 韩红亚[1] 刘宇杨[1] 史冬梅[1] 胡斌[1] 杨士伟[1] 

机构地区：[1]首都医科大学附属北京安贞医院心内科12病房,100029

出　　处：《中华老年心脑血管病杂志》2013年第9期903-905,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的研究高龄糖尿病合并心房颤动(房颤)患者血清高敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)水平的变化及与颈动脉粥样硬化程度的相关性,探讨炎症、氧化应激在糖尿病合并房颤的发生、发展中的变化及意义。方法选择高龄糖尿病合并房颤患者(房颤组)115例,糖尿病窦性心律患者(窦律组)103例及窦性心律除外糖尿病者(对照组)98例。房颤组中阵发性房颤42例、持续性房颤37例及永久性房颤36例。检测各组hs-CRP和Hcy水平;颈动脉超声检测颈动脉内膜中层厚度(IMT)及斑块Crouse积分,评价颈动脉粥样硬化情况。结果与对照组比较,房颤组和窦律组hs-CRP、Hcy、IMT和斑块Crouse积分明显升高(P<0.05);与窦律组比较,房颤组上述指标明显升高(P<0.05)。房颤组患者hs-CRP、Hcy与房颤持续时间呈正相关(r=0.64、r=0.53,P<0.05),与IMT和斑块Crouse积分呈正相关(r=0.59、r=0.66,P<0.05)。结论炎症和氧化应激在高龄糖尿病合并房颤时颈动脉粥样硬化的发生、发展可能起重要作用,而且随着房颤的持续而加重,hs-CRP、Hcy水平与糖尿病合并房颤的发生、发展及颈动脉粥样硬化的严重程度密切相关。Objective To study the correlation of hs-CRP and Hcy with carotid atherosclerosis in advance-aged DM patients with atrial fibrillation （AF） and the significance of inflammation and oxidation stress in the occurrence and progress of DM and AF. Methods One hundred and fifteen advance-aged DM patients with AF served as an AF group, 103 DM patients with sinus rhythm served as a sinus rhythm group, and 98 non-DM subjects with sinus rhythm served as a control group in this study. The AF group was subdivided into paroxysmal AF group （n=42） ,persistent AF group （n=37） and permanent AF group （n=36）. Their serum hs-CRP and Hcy levels,carotid IMT were measured,plaque Crouse score was recorded,and carotid atherosclerosis was assessed. Results The serum hs-CRP and Hcy levels, IMT and plaque Crouse score were significantly higher in AF group and sinus rhythm group than in control group （P〈0.05） and in AF group than in sinus rhythm group （P〈0.05）. The serum hs-CRP and Hcy levels were positively correlated with the persistent time of AF （r=0.64,r=0.53,P%0.05） while the IMT was positively correlated with the plaque Crouse score （r=0.59,r=0.66,P%0.05）. Conclusion Inflammation and oxidation stress play an important role in the occurrence and progress of carotid atherosclerosis that aggregates with AF and the serum hs-CRP and Hcy levels are closely correlated with the severity of carotid atherosclerosis in advance-aged DM patients with AF.

关 键 词：糖尿病 C反应蛋白质 心房颤动 高半胱氨酸 颈动脉疾病 动脉粥样硬化 

分 类 号：R587.1[医药卫生—内分泌] R541.75[医药卫生—内科学]