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目的:探讨血浆C反应蛋白(CRP)水平的变化对冠心病并发Ⅱ型糖尿病(DM)患者的临床意义。方法:经冠脉造影诊断的冠心病患者61例,按有无并发糖尿病分为并发糖尿病组(30例),单纯冠心病组(31例),所有研究对象测定空腹静脉血、CRP、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血脂等指标,并结合冠脉造影结果计算Gensini评分,将各指标进行组间比较,并进行多元回归分析。结果:并发糖尿病组血CRP、FBG、HbA1c均显著高于单纯冠心病组(P<0.01);并发糖尿病组患者的冠脉病变Gensini评分和三支病变者明显多于单纯冠心病组患者(P<0.05);经线性回归分析显示,冠状动脉病变严重程度与CRP、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、体质量指数(BMI)显著相关(均P<0.01)。结论:冠心病患者并发Ⅱ型糖尿病将加重冠状动脉病变严重程度,糖尿病患者血清CRP水平升高不仅是糖尿病并发冠心病的重要危险因子,也是反映糖尿病冠状动脉广泛弥漫和严重病变的重要指标。
Objective: To investigate the clinical significance of the changes of plasma C-reactive protein (CRP) levels in patients with coronary heart disease complicated with type 2 diabetes mellitus (DM). Methods: 61 cases of CHD diagnosed by coronary angiography were divided into complicated diabetes mellitus (30 cases) and simple coronary heart disease group (31 cases) with or without diabetes mellitus. All the subjects were tested for fasting venous blood, CRP, fasting blood glucose (FBG), HbA1c, blood lipid and other indicators, combined with coronary angiography results calculated Gensini score, the indicators were compared between groups, and multiple regression analysis. Results: The blood levels of CRP, FBG and HbA1c in patients with diabetes mellitus were significantly higher than those in patients with simple coronary heart disease (P <0.01). The Gensini scores and three lesions in patients with diabetes mellitus were significantly higher than those in patients with coronary heart disease <0.05). The linear regression analysis showed that the severity of coronary artery disease was positively correlated with the severity of coronary artery disease and the severity of coronary artery disease such as CRP, TG, TC, HDL-C and LDL- C) and body mass index (BMI) (all P <0.01). Conclusions: Patients with coronary heart disease complicated by type 2 diabetes mellitus will aggravate the severity of coronary artery disease. Elevated serum CRP level is not only an important risk factor of diabetes mellitus complicated by coronary heart disease, but also an important indicator of extensive diffuse and severe coronary artery disease.