摘要
目的探讨冠心病病人胰岛素抵抗与高敏C反应蛋白(high sensitivity-C reactive protein,hs-CRP)及冠状动脉病变严重程度之间的关系。方法经冠状动脉造影确诊冠心病308例,稳定性心绞痛212例,年龄(62±11)岁;急性冠状动脉综合征96例,年龄(62±11)岁。分为3组:Ⅰ组123例,为非糖尿病无糖耐量异常病人;Ⅱ组87例,为糖耐量异常病人;Ⅲ组98例,为糖尿病病人。对照组92例经冠状动脉造影排除冠心病。测定空腹血糖、早餐后2h血糖、血脂、空腹胰岛素、hs-CRP、糖化血红蛋白水平。结果hs-CRP:Ⅰ组:(50±15)mg/L,Ⅱ组(55±14)mg/L;Ⅲ组(62±20)mg/L,差异无统计学意义,但均明显高于对照组(6.5±5.7)mg/L;hs-CRP在急性冠状动脉综合征病人为(8.4±2.6)mg/L,明显高于稳定性心绞痛病人(52±18)mg/L和非冠心病病人(6.5±5.7)mg/L;在糖尿病病人,无论是否患冠心病,血浆hs-CRP与糖化血红蛋白、空腹胰岛素及胰岛素抵抗指数之间存在正相关,而与空腹血糖、2h血糖及血脂水平无相关;糖化血红蛋白、空腹胰岛素、胰岛素抵抗指数及血脂与冠状动脉病变支数及冠状动脉狭窄程度相关,而hs-CRP与此无相关。结论冠心病合并糖尿病患与否对hs-CRP水平不产生明显影响。hs-CRP水平是冠心病急性心脏事件发生的高危预测指标。
Objectives To investigate the relevance between the high sensitive C-reactive protein （hs- CRP） and insulin resistance index （IRI） and the severity of coronary artery disease （CAD） . Methods 308 CAD patients diagnosed by coronary anglography （CAG） were divided into 3 groups： Group Ⅰ （123 patients without diabetes mellitus and impaired glucose tolerance）, Group Ⅱ （87 patients with impaired glucose tolerance） and Group Ⅲ （98 patients with diabetes mellitus）. Free blood glucose （FBG）, 2h postprandial blood glucose （2hBG）, blood lipids, fasting insulin （FINS）, hs-CRP and hemoglobin Ale （HbA1C） were determined. IR/was calculated by HOMA model and the severity of coronary artery disease were reflected by the degree of coronary stenosis and numbers of diseased coronary arteries. 92 patients without CAD diagnosed by CAG were enrolled into control group （Group C）, and all the CAD patients were divided into 2 groups （ACS group-96 patients and non-ACS group-212 patients）. Results There were no obvious statistical difference in the level of hs-CRP among Group Ⅰ , Group Ⅱ and Group Ⅲ, but the level of hs-CRP in aforesaid 3 groups was much higher than that of Group C, and hs-CRP of ACS group was higher than that of non-ACS group and Group C. There was obvious positive correlation between hs-CRP and HbA1C, FINS and IRI, but there was no obvious correlation between hs-CRP and FBG, 2hBG and blood lipids. There were obvious correlation between HbA1C, FINS, IRI, blood lipids and the severity of CAD, but there was no between hs- CRP and the severity of CAD. Conclusions It has no obvious effect on the level of hs-CRP in spite of with or without DM in CAD patients, hs-CRP is the better index to forecast the acute heart events. There is apparent correlation between hs-CRP and HbA1C, FINS, IRI, but there is no between hs-CRP and FBG, 2hBG, blood lipids. There is obvious correlation between the severity of CAD and HbA1C, FINS, IRI, blood lipids, but there is no between it and hs-CRP.
出处
《岭南心血管病杂志》
2007年第1期45-47,共3页
South China Journal of Cardiovascular Diseases
关键词
高敏C反应蛋白
胰岛素抵抗指数
冠心病
糖尿病
High sensitive-CRP
Insulin resistance index
Coronary artery disease
Diabetes mellitus
