目的：研究冠心病合并2型糖尿病患者糖化血红蛋白与冠脉病变严重程度的相关性，并进一步探讨糖化血红蛋白对冠脉病变严重程度的预测价值。方法：搜集并回顾性分析2018年6月至2020年6月安徽医科大学第一附属医院心内科冠心病合并2型糖尿病患者(共259例)的资料，计算SYNTAX积分，根据冠脉病变严重程度分为低危组(SYNTAX积分≤22分)100例，中危组(22分32分)72例。比较分析3组间的一般临床资料、实验室检验及检查指标，采用Logistic回归分析糖化血红蛋白与冠脉病变严重程度的相关性，绘制受试者工作特征(ROC)曲线进一步评价糖化血红蛋白对冠心病合并2型糖尿病患者冠脉病变严重程度的预测价值。结果：高危组患者糖尿病病程较低危组和中危组更长(P<0.05)。高危组患者入院时空腹血糖、急诊血糖、糖化血红蛋白水平高于低危组和中危组(P<0.05)，其他检验和检查指标3组患者间比较差异无统计学意义(P>0.05)。Logistic回归分析显示，糖化血红蛋白与冠心病合并2型糖尿病患者冠脉高危病变相关。ROC曲线结果显示，糖化血红蛋白预测冠心病合并2型糖尿病患者冠脉高危病变曲线下面积为0.791，最佳临界值为8.05%，灵敏度为75%，特异度为79%。结论：糖化血红蛋白与冠心病合并2型糖尿病患者冠脉高危病变相关，糖化血红蛋白>8.05%对冠脉高危病变有预测价值，在一定程度上对冠脉高危病变的识别提供指导。

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