冠心病患者糖化血红蛋白与冠脉病变严重程度的相关性  

CORRELATION BETWEEN GLYCATED HEMOGLOBIN HbA1c LEVELS AND SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS WITH CORONARY HEART DISEASE

作　　者：杨辉剑[1] 田相亭[1] 钟志安[1] 魏水生[1] 曾平[1] 

机构地区：[1]广东省人民医院,广东广州510100

出　　处：《现代医院》2014年第6期31-33,共3页Modern Hospitals

基　　金：广东省科技计划项目(编号:2011B031700001)

摘　　要：目的探讨明确冠心病诊断的患者中糖化血红蛋白（HbA1c）与冠脉病变严重程度的相关性。方法选择行冠脉造影明确冠心病诊断的患者共298例，按糖化血红蛋白水平共分为三组：第一组〈5．5％（n=31）。第二组5．5％-6．5％（n=177），第三组〉6．5％（n=90），应用Gensini评分评估患者冠脉病变的严重程度。结果高水平糖化血红蛋白组（HbA1c〉6．5％）与中低水平糖化血红蛋白组相比空腹血糖、餐后2h血糖及糖尿病病史有显著统计学差异（p〈0．001）。应用Spearman等级相关结果显示：糖化血红蛋白（HbA1c）于冠脉病变Gensini评分无明显相关（r=0．024，p=0．684），校正年龄、性别、吸烟状况、BMI、空腹血糖、餐后2h血糖、尿酸、甘油三酯、总胆固醇、低密度脂蛋白、高密度脂蛋白、APO—A、APO—B、高敏C反应蛋白多因素后Spearman偏等级相关（r=0．061，p=0．364）。结论糖化血红蛋白（HbA1c）〉6．5％可作为糖尿病诊断的辅助指标之一，但糖化血红蛋白的水平与冠脉病变的严重程度无明显关联。Objective To investigate the relationship between level of glycated hemoglobin HbA1c and severity of coronary lesions in patient confirmed coronary heart disease. Methods 298 cases confirmed coronary heart disease by coronary angiography were grouped into three according to the level of glycated hemoglobin： the first group of 〈5.5% （n =31 ）, the second group 5.5% - 6.5% （n = 177） the third group 〉 6. 5% （n = 90）. Gensini score was applied to assessment the severity of coronary lesions. Results higher glycated hemoglobin group had significant higher fasting blood glucose and two hours postprandial blood glucose level and higher prevalence of diabetes muUites compared with the other two groups （p 〈 0. 001 ）. The Gensini score did not receive principle of statistics significance with level of glycated hemoglobin HbA1c （r = 0. 024,p =0. 684） ,After adjusted the potential risk factors such as age,sex,smoking,BMI,fasting serum glucose,two - hour postprandial blood glucose ,UA ,TG,TC ,LDL- C ,HDL- C, HSCRP with Spearman partial correlation test, HbA1c level had no conspicuous relationship with Gensini score （r = 0. 061 ,p = 0. 364）. Conclusion Glycated hemoglobin （ HbA1c 〉 6.5% ） could used as one of the auxiliary indicators diagnosis diabetes, but unrelated to the severity of coronary lesions.

关 键 词：冠心病 糖化血红蛋白 冠状动脉病变程度 

分 类 号：R587.1[医药卫生—内分泌]