非糖尿病急性冠脉综合征患者血清糖化血红蛋白的变化及临床相关性  

The level of serum glycosylated hemoglobin in nondiabetic patients with acute coronary syndrome and it＆#39;s clinical relevance

作　　者：韩玉龙[1] 梁立龙[1] 许明生[1] 张建[1] 杨林飞[1] 

机构地区：[1]合肥市第二人民医院心血管内科,安徽省合肥市230011

出　　处：《中国心血管病研究》2014年第11期1022-1025,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨糖化血红蛋白（HbA1c）能否作为非糖尿病急性冠脉综合征（ACS）患者冠脉病变情况及病情评估的一个指标.方法 选择非糖尿病的ACS患者60例,测定其血清HbA1c水平,同时测定随机血糖、空腹血糖、高敏C反应蛋白（hs-CRP）、肌钙蛋白、肌酸激酶同工酶（CK-MB）、低密度脂蛋白胆固醇（LDL-C）,并行选择性左右冠状动脉造影.结果 非糖尿病的ACS患者血清HbA1c水平明显高于稳定型心绞痛组和非冠心病组患者（P＜0.01）,且与hs-CRP呈显著正相关（rs=0.725,P=0.002）;与随机血糖及空腹血糖呈显著正相关（rs=0.665,P=0.007）;与LDL-C有较弱相关性（rs=0.535,P=0.49）,但差异无统计学意义.HbA1c水平与肌钙蛋白I（rs=0.41,P=0.129）、CK-MB（rs=0.415,P=0.124）没有相关性.HbA1c水平和冠脉病变支数呈明显正相关（rs=0.813,P=0.006）;与Jenkins积分呈正相关（rs=0.745,P=0.022）.结论 HbA1c可反映非糖尿病ACS患者病情严重程度,可作为心血管事件高发及预后不良的一个评估指标.Objective To investigate the clinical value of glycosylated hemoglobin（ HbAlc ） in nondiabet- ic patients with acute coronary syndrome. Methods This observational study included consecutive patients（n=60） without known diabetes mellitus admitted with acute coronary syndrome. Both admission glucose and troponin I, CK-MB were measured on admission. The serum HbAlc, fasting plasma glucose, hs-CRP and LDL-C were measured in the next day, and the coronary angiography （CAG） was performed in all patients. Results In nondia- betic patients with ACS, circulating HbAlc levels were significantly higher than that in patients with stable angina and non-CHD（P〈0.01 ）, HbAlc levels correlated obviously with levels of hs-CRP（rs=0.725, P=0.002）, admis- sion glucose and fasting plasma glucose（r,=0.665, P=0.007）, but not with markers of myocardial injury（troponin I and CK-MB）, there was obviously correlation between the levels of serum HbAlc and Jenkins score（r~=0.745, P= 0.022）, the number of stenosis vessels（r,=0.813, P=0.006）. Conclusion Circulating HbA1c levels are elevate in nondiabetic patients with ACS and correlate with hs-CRP, glucose, LDL-C, the number of stenosis vessels and degree of coronary artery stennsis but not correlate with troponin I, CK-MB, HbA1c can contribute to a comprehensive understanding of the severity of the ACS 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 血糖 

分 类 号：R543.3[医药卫生—心血管疾病]