糖尿病并发冠心病患者的血清胱抑素C水平及其临床意义  

Serum cystatin C level and its clinical significance in diabetic patients complicated with coronary heart disease

作　　者：王朗[1] 周佳莉[1] WANG Lang;ZHOU Jia-li(Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院心内科,湖北省武汉市430060

出　　处：《广西医学》2020年第15期1946-1949,共4页Guangxi Medical Journal

摘　　要：目的探讨糖尿病并发冠心病患者血清胱抑素C水平及其临床意义。方法选择205例单纯糖尿病患者(糖尿病组)及422例糖尿病并发冠心病患者(糖尿病+冠心病组),比较两组血清胱抑素C及超敏C反应蛋白(hs-CRP)水平。根据冠状动脉累及情况将糖尿病+冠心病组患者分为单支病变组(n=184)、双支病变组(n=125)和三支病变组(n=113),另根据Gensini积分将其分为高分组(n=227)和低分组(n=195),比较相关亚组间的血清胱抑素C水平。分析糖尿病并发冠心病患者血清胱抑素C水平与Gensini积分、hs-CRP水平和左室射血分数的相关性。结果糖尿病+冠心病组血清胱抑素C及hs-CRP水平均高于糖尿病组(均P<0.05)。单支病变组、双支病变组及三支病变组患者血清胱抑素C水平依次升高,Gensini积分高分组胱抑素C水平高于低分组(均P<0.05)。糖尿病并发冠心病患者血清胱抑素C水平与Gensini积分及hs-CRP水平呈正相关,而与左室射血分数呈负相关(均P<0.05)。结论糖尿病并发冠心病患者血清胱抑素C水平升高。胱抑素C或通过参与炎症反应等病理过程在糖尿病患者冠心病的发生与发展中发挥作用,检测其血清水平有助于评估糖尿病患者冠状动脉病变严重程度和心功能。Objective To explore serum cystatin C level and its clinical significance in diabetic patients complicated with coronary heart disease(CHD).Methods A total of 205 patients with diabetes alone(diabetes group)and 422 diabetic patients complicated with CHD(diabetes+CHD group)were included,and serum cystatin C and high-sensitivity C-reactive protein(hs-CPR)levels were compared between the two groups.Patients in the diabetes+CHD group were sub-grouped into single-vessel group(n=184),double-vessel group(n=125)and triple-vessel group(n=113)according to coronary involvement,and were sub-grouped into high-score group(n=227)and low-score group(n=195)according to Gensini score,then serum cystatin C level was compared between different subgroups.Among the diabetic patients complicated with CHD,the correlation of serum cystatin C level with Gensini score,hs-CRP level and left ventricular ejection fraction was analyzed.Results Serum levels of cystatin C and hs-CRP in the diabetes+CHD group were higher than those in the diabetes group(all P<0.05).Serum cystatin C level increased in the single-vessel group,the double-vessel group and the triple-vessel group successively,and was higher in the high-score group with high Gensini score than that in the low-score group(all P<0.05).Among diabetic patients complicated with CHD,serum cystatin C level positively correlated with Gensini score and hs-CRP level,but negatively correlated with left ventricular ejection fraction(all P<0.05).Conclusion Serum cystatin C level is elevated in the diabetic patients complicated with CHD.Cystatin C exerts an effect on the occurrence and development of CHD probably by participating in inflammatory response and other pathological process among diabetic patients,their serum level might contribute to evaluating coronary lesion severity and cardiac function of diabetic patients.

关 键 词：糖尿病 冠心病 胱抑素C 心功能 GENSINI积分 超敏C反应蛋白 

分 类 号：R587.1[医药卫生—内分泌]