摘要
目的:探讨空腹血糖、果糖胺以及糖化血红蛋白水平与世居高原人群冠心病的发病以及冠状动脉病变程度的相关性。方法:入选于我院行冠状动脉造影检查的世居高原患者1 035例,所有患者家族至少连续三代居住于高原地区。按照冠状动脉造影结果分为冠心病组和对照组。测定空腹血糖(FPG)、果糖胺(FMN)、糖化血红蛋白(HbAlc)水平;同时测定患者Gensini评分。再将冠心病组分为单纯冠心病组和糖尿病合并冠心病组、不稳定型心绞痛组和急性心肌梗死组等亚组,分别进行统计分析。结果:两组患者吸烟史、高血压病史、糖尿病史差异均有统计学意义(P<0.05);冠心病组FPG、FMN、HbAlc水平与对照组差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,患者吸烟史、高血压病史、糖尿病史以及FPG、FMN、HbAlc水平升高是冠心病的危险因素。在冠心病组的亚组分析中糖尿病合并冠心病组的FPG、FMN、HbAlc以及Gensini评分均高于单纯冠心病组(P<0.05);急性心肌梗死组的FPG、Gensini评分均高于不稳定型心绞痛组(P<0.05),但两组间FMN、HbAlc差异无统计学意义(P>0.05)。结论:糖代谢异常与世居高原人群冠心病的发生以及严重程度明确相关,并且FPG、FMN、HbAlc升高可以作为世居高原人群冠心病的危险因素以及严重程度的预测因子;并且FPG、FMN、HbAlc联合检测,对急性心肌梗死应激状态下血糖升高的原因有重要的鉴别意义。
Objective:This paper aims to investigate the relationship between the levels of fasting glucose,fructose,glycosylated hemoglobin and the incidence of coronary heart disease and the pathology degree of coronary artery disease.Methods:1 035 cases who intended to diagnose of coronary artery disease and underwent coronary angiography were selected,and all the patients live in the plateau for at least three consecutive generations.According to the coronary angiography results,they were divided into coronary artery disease group and control group.Fasting blood glucose(FPG),Gensini(FMN)and glycosylated hemoglobin(HbAlc)levels were measured,and the patients' scores were measured simultaneously.The coronary heart disease group was respectively divided into CHD group,diabetes mellitus with coronary heart disease group,unstable angina pectoris and acute myocardial infarction group and other groups,the clinical data of which were respectively collected for statistical analysis.Results:The differences of two groups of patients with smoking history,history of hypertension,history of diabetes were statistically significant(P<0.05);FPG,FMN,HbAlc in CHD group and the control group had significant difference(P=0.000;P=0.047;P=0.000).Multivariate Logistic regression analysis showed that smoking history,hypertension history,diabetes history,elevated levels of FPG,FMN and HbAlc were risky factors of coronary heart disease.In the subgroup analysis of coronary heart disease group in diabetic patients with coronary heart disease group,FPG,FMN,HbAlc and Gensini were higher than those of simple CHD group(P<0.05);The score of FPG and Gensini in acute myocardial infarction group was higher than that in unstable angina group(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusion:Abnormal glucose metabolism and native specifically related to the occurrence of coronary heart disease in Plateau and severity,meanwhile,FPG,FMN and HbAlc increased risky factors as predictors of coronary heart disease in Plateau and severity.Therefore,the combined detection of FPG,FMN,HbAlc has an identified significance to state the reasons for glucose rise under acute myocardial infarction.
引文
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