2型糖尿病合并冠心病患者血清γ谷氨酰胺转移酶与冠脉病变严重程度的相关性  

Correlation of serum gamma glutamine transferase with coronary artery culprit lesions in type 2 diabetic patients with coronary artery diseases

作　　者：闫庆凯[1] 邓宜鹂[1] 方慧[1] 王旭开[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所心血管内科,重庆400042

出　　处：《第三军医大学学报》2014年第15期1610-1613,共4页Journal of Third Military Medical University

基　　金：国家自然科学基金(81170281)~~

摘　　要：目的探讨2型糖尿病合并冠心病患者血清γ谷氨酰胺转移酶（gammaglutaminetransferase，GGT）与冠脉病变严重程度的相关性，研究血清GGT的升高在冠心病评估中的重意义。方法选取在我院接受冠状动脉造影的2型糖尿病患者226例为研究对象，选择性冠脉造影后根据有无冠脉病变分成冠脉病变组和冠脉正常组。计算冠脉病变组的Gensini积分；测定两组患者的血清GGT及其他致冠心病危险因素水平[体质量指数（BMI）、低密度脂蛋白胆固醇（LDL—c）、胰岛素C肽等]，分析GGT及其他危险因素与Gensini积分的相关性。结果226例患者中，冠脉病变组的年龄、BMI、LDL-c、高密度脂蛋白胆固醇（HDL—c）、GGT、胰岛素C肽、Gensini积分与冠脉正常组比较差异有统计学意义（P〈0．05），而其他因素如性别、空腹血糖值（Glu）、糖化血红蛋白（HbAlc）、收缩压、舒张压、总胆固醇（TC）、甘油三酯（TG）、血清谷草转氨酶（AST）、血清谷丙转氨酶（ALT）、血清肌酐（Scr）、血清白蛋白（ALB）比较差异则无统计学意义。根据Gensini积分将患者分成低分组（〈20分）、中分组（20～40分）、高分组（〉40分）3个亚组，并将冠脉正常组作对照组，冠脉病变患者各亚组GGT与正常对照组有统计学差异（P〈0．01），而胰岛素C肽则仅为高分组与正常对照组有统计学差异（P〈0．01）。在冠脉病变组，高分组患者的GGT、胰岛素C肽显著高于低分组、中分组患者（P〈0．01）。相关分析显示，在2型糖尿病合并冠心病患者中，LDL—C与血清GGT水平及冠脉狭窄程度积分呈正相关，相关系数分别为（r=0．373，P〈0．01）和（r=0．264，P〈0．01）。ROC曲线分析结果显示GGT的面积为0．674（0．598—0．750），仅低于BMI（0．703）、LDL-c（0．687），而高于年龄（0．640）、胰岛素C肽（0．592）、HDL—c（0．379）。结�Objective To investigate the correlation of serum level of gamma glutamine transferase （GGT） with the severity of coronary artery lesions in patients with type 2 diabetes accompanied with coronary artery diseases （CHD） and explore the significance of serum GGT in evaluation of CHD. Methods A total of 226 patients with type 2 diabetes who receiving coronary angiography in our hospital from March 2012 to March 2013 were recruited in this study. These patients were divided into coronary lesions group calculated with the Gensini score） and normal coronary artery group according to the results of selective coronary angiography. The serum level of GGT was measured, and other risk factors and components of CHD, such as body mass index （BMI） Among , low-density lipoprotein cholesterol （LDL-c） , these 226 patients, there were statistical signifi and insulin-C peptide were also detected. Results cance in the age, BMI, LDL-c, HDL-c, GGT, insulin- C peptide and Gensini score between the coronary lesion group and normal coronary artery group （P 〈 0.05 ） , while there was no difference in other factors such as gender, Glu, systolic pressure, diastolic pressure, TC, TG, AST, ALT, serum creatinine, serum albumin between them. According to the level of the Gensini score, the coronary lesion group were further divided into 3 subgroups, i. e. , the high （ 〉 40）, middle （20 to 40）, and low （ 〈 20） score groups, and the normal coronary group was employed for comparative analysis. The GGT level of all subgroups and normal control group was statistically difference （P 〈 0.01 ）, whereas for the insulin- C peptide, only the high group and normal control group had statistically significant （P 〈0.01 ）. What＇s more, both levels of GGT and insulin-C peptide were significantly higher in the high score group than in the middle and low score groups （ P 〈 0.01 ）. In the type 2 diabetic patients with coronary artery disease, the levels of plasma LDL-c and serum GGT were positively corre

关 键 词：糖尿病 冠心病 γ谷氨酰胺转移酶 

分 类 号：R446.112[医药卫生—诊断学] R541.4[医药卫生—临床医学]