小而密低密度脂蛋白与2型糖尿病患者冠脉损害的关系  

Relationship between Small and Dense Low-density Lipoproteins and Coronary Artery Damage in Patients with Type 2 Diabetes

作　　者：赵晓黎 ZHAO Xiao-li(Department of Internal Medicine,Shandong Liangzhuang Mining Co.,Ltd.Xintai,Shandong Province,271219 China)

机构地区：[1]山东良庄矿业有限公司医院内科,山东新泰271219

出　　处：《系统医学》2020年第10期63-65,共3页Systems Medicine

摘　　要：目的探讨小而密低密度脂蛋白(sd-LDL)与2型糖尿病(T2DM)患者冠状动脉损害的关系。方法选择2018年1月—2019年2月526例T2DM患者,采用超声评价冠脉损害发生情况,合并冠状动脉病变纳入研究组(n=182),无冠状动脉病变患者纳入对照组(n=344),检测脂代谢、糖代谢相关指标及血清hs-CRP,采用t检验进行单因素分析冠脉损害的相关因素,采用Logstic多因素分析T2DM冠状动脉损害的危险因素。结果总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)、SdLDL-C、hs-CRP、空腹血糖(FPG)及HbA1c在对照组分别为(3.89±0.61) mmol/L、(2.39±0.52) mmol/L、(2.84±0.49) mmol/L、(0.62±0.07) mmol/L、(0.49±0.07) mmol/L、(0.42±0.06)mmol/L、(5.89±1.06)mg/L、(4.19±0.22)%,在研究组分别为(4.47±0.59)mmol/L、(2.41±0.57)mmol/L、(3.54±0.51)mmol/L、(0.49±0.05)mmol/L、(0.64±0.11)mmol/L、(0.76±0.09)mmol/L、(5.96±1.17)mg/L、(6.16±0.31)%,两组TG、FPG水平差异无统计学意义(P>0.05),研究组患者HbA1c、TC、LDL-C、sdLDL-C、hs-CRP高于对照组(P<0.05),HDL-C低于对照组(P<0.05),Logistic多因素分析结果显示,sdLDL-C、hs-CRP及HbA1c是T2DM发生冠状动脉损害的独立影响因素[OR=2.144、1.597、1.214,95%CI(1.319~3.526)、95%CI(1.174~2.258)、95%CI(1.062~1.954)]。结论 T2DM并发心血管损害的影响因素较多,长期血糖控制不良、sdLDL-C和hs-CRP增高,增加T2DM发生冠脉损害的风险。Objective To investigate the relationship between small and dense low-density lipoprotein(sd-LDL) white and coronary artery damage in patients with type 2 diabetes(T2DM). Methods From January 2018 to February 2019,526 T2DM patients were selected. The incidence of coronary damage was evaluated by ultrasound. Coronary artery disease was included in the study group(n=182). Patients without coronary artery disease were included in the control group(n =344), to detect lipid metabolism, glucose metabolism-related indicators and serum hs-CRP, t-test for univariate analysis of related factors of coronary artery damage, Logstic multivariate analysis of risk factors for T2DM coronary artery damage. Results Total cholesterol(TC), triglyceride(TG), low density lipoprotein(LDL-C), high density lipoprotein(HDL-C), SdLDL-C, hs-CRP, fasting blood glucose(FPG) and HbA1c were in the control group:(3.89 ±0.61) mmol/L,(2.39±0.52) mmol/L,(2.84±0.49) mmol/L,(0.62±0.07) mmol/L,(0.49±0.07) mmol/L,(0.42±0.06) mmol/L,(5.89±1.06) mg/L,(4.19±0.22)%, and the study group of(4.47±0.59) mmol/L,(2.41±0.57) mmol/L,(3.54±0.51) mmol/L,(0.49±0.05) mmol/L,(0.64±0.11) mmol/L,(0.76±0.09) mmol/L,(5.96±1.17) mg/L,(6.16±0.31)%, the difference were no statistically significant in FPG and TG between the two groups(P>0.05), HbA1 c, TC, LDL-C, sdLDL-C, hs-CRP in the study group was higher than the control group(P<0.05), HDL-C was lower than the control group(P<0.05). Logistic multivariate analysis results show that sdLDL-C, hs-CRP, and HbA1c are independent of coronary artery damage in T2DM Influencing factors[OR=2.144,1.597,1.214, 95%CI(1.319-3.526), 95%CI(1.174-2.258), 95% CI(1.062-1.954)].Conclusion There are many factors affecting cardiovascular damage in T2DM. Long-term poor glycemic control,increased sdLDL-C and hs-CRP increase the risk of coronary damage in T2DM.

关 键 词：2型糖尿病 心血管损害 小而密低密度脂蛋白 糖化血红蛋白 超敏C反应蛋白 

分 类 号：R587[医药卫生—内分泌]