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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关系
作者:程宝山  梁丰  王春苗  骆志刚  梁有峰  赵韧 
单位:安徽医科大学第一附属医院 心内科, 安徽 合肥 236000
关键词:冠心病 2型糖尿病 糖化血红蛋白 冠脉病变 
分类号:R541.4;R587.1
出版年·卷·期(页码):2022·50·第三期(290-294)
摘要:

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。

参考文献:

[1] 胡盛寿,高润霖,刘历生,等.《中国心血管病报告2018》概要[J].中国循环杂志,2019,34(3):209-220.
[2] 国家心血管病中心.中国心血管健康与疾病报告2020[J].心肺血管病杂志,2021,40(9):885-889.
[3] LIU Z,FU C,WANG W,et al.Prevalence of chronic complications of type 2 diabetes mellitus in outpatients-a cross-sectional hospital based survey in urban China[J].Health Qual Life Outcomes,2010,8(10):62-70.
[4] BRAGG F,HOLMES M V,LONA A,et al.Association between diabetes and cause-specific mortality in rural and urban areas of China[J].JAMA,2017,317(3):280-289.
[5] SACKS D B,ARNOLD M,BAKRIS G L,et al.Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus[J].Diabetes Care,2011,34(6):e61-99.
[6] BASMAN C,FISHMAN S L,AVTANSKI D,et al.Glycosylated hemoglobin,but not advanced glycation end products,predicts severity of coronary artery disease in patients with or without diabetes[J].Metabol Open,2020,7(8):1-9.
[7] SU W Y,CHEN S C,HUANG Y T,et al.Comparison of the effects of fasting glucose,hemoglobin A1c,and triglyceride-glucose index on cardiovascular events in type 2 diabetes mellitus[J].Nutrients,2019,11(11):2838-2850.
[8] 侯晓沛,田艳蒙,许亮,等.糖化血红蛋白水平对稳定性冠心病合并2型糖尿病患者冠状动脉病变程度的影响[J].中国循环杂志,2018,33(5):435-440.
[9] SHEN Y,PU L J,LU L,et al.Glycated albumin is superior to hemoglobin A1c for evaluating the presence and severity of coronary artery disease in type 2 diabetic patients[J].Cardiology,2012,123(2):84-90.
[10] JIANG J,ZHAO L,LIN L,et al.Postprandial blood glucose outweighs fasting blood glucose and HbA1c in screening coronary heart disease[J].Sci Rep,2017,7(1):1-7.
[11] SERRUYS P W,MORICE M C,KAPPETEIN A P,et al.Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease[J].N Engl J Med,2009,360(10):961-972.
[12] MOHAR D S,SALCEDO J,HOANG K C,et al.Epicardial adipose tissue volume as a marker of coronary artery disease severity in patients with diabetes independent of coronary artery calcium:findings from the CTRAD study[J].Diabetes Res Clin Pract,2014,106(2):228-235.
[13] SALEEM T,MOHAMMAD K H,ABDEL-FATTAH M M,et al.Association of glycosylated haemoglobin level and diabetes mellitus duration with the severity of coronary artery disease[J].Diab Vasc Dis Res,2008,5(3):184-189.
[14] UL AMIN R,AHMEDANI M A M,KARIM M,et al.Correlation between Gensini score and duration of diabetes in patients undergoing coronary angiography[J].Cureus,2019,11(2):e4010-4019.
[15] ESCOBEDO J,RANA J S,LOMBARDERO M S,et al.Association between albuminuria and duration of diabetes and myocardial dysfunction and peripheral arterial disease among patients with stable coronary artery disease in the BARI 2D study[J].Mayo Clin Proc,2010,85(1):41-46.
[16] ZHANG X,XU X,JIAO X,et al.The effects of glucose fluctuation on the severity of coronary artery disease in type 2 diabetes mellitus[J].J Diabetes Res,2013,2013(7):1-6.
[17] QIN Y,YAN G,QIAO Y,et al.Relationship between random blood glucose,fasting blood glucose,and GENSINI score in patients with acute myocardial infarction[J].Biomed Res Int,2019,2019(9):1-10.
[18] YU Y,ZHOU Z,SUN K,et al.Association between coronary artery atherosclerosis and plasma glucose levels assessed by dual-source computed tomography[J].J Thorac Dis,2018,10(11):6050-6059.
[19] FU C P,SHEU W H,LEE W L,et al.Two-hour post-challenge hyperglycemia,but not fasting plasma glucose,associated with severity of coronary artery disease in patients with angina[J].PLoS One,2018,13(8):e1-9.
[20] ASHRAF H,BOROUMAND M A,AMIRZADEGAN A,et al.Hemoglobin A1C in non-diabetic patients:an independent predictor of coronary artery disease and its severity[J].Diabetes Res Clin Pract,2013,102(3):225-232.
[21] MA X,HU X,ZHOU J,et al.Glycated albumin is more closely correlated with coronary artery disease than 1,5-anhydroglucitol and glycated hemoglobin A1c[J].Cardiovasc Diabetol,2015,14(2):16-22.
[22] LEONG A,CHEN J,WHEELER E,et al.Mendelian randomization analysis of hemoglobin A1c as a risk factor for coronary artery disease[J].Diabetes Care,2019,42(7):1202-1208.

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