糖化血红蛋白在动脉粥样硬化发病机制中的作用研究

摘要
图/表
参考文献(20)
相关文章 (15)

全文: PDF (632 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨糖化血红蛋白（HbA1c）在动脉粥样硬化发生、发展中的作用。方法选择2015年1月~2016年12月上海交通大学医学院附属第九人民医院收治的120例冠心病（CHD）患者及40例健康体检者（对照组），据冠脉造影结果进行分组，其中120例CHD患者包括急性心肌梗死组（AMI组）40例、不稳定型心绞痛组（UAP组）40例、稳定型心绞痛组（SAP组）40例。采用彩色多普勒超声诊断仪测定颈动脉内膜-中层厚度（IMT）；采用数字减影心血管造影机行选择性冠状动脉造影，应用Gensini冠状动脉病变积分方法评价冠状动脉病变严重程度；采用酶法测定HbA1c、血脂等指标。结果 AMI组、UAP组、SAP组患者HbA1c水平及IMT均显著高于对照组（P < 0.01）；且AMI组、UAP组患者HbA1c水平明显高于SAP组患者（P < 0.01）；AMI组、UAP组患者IMT明显高于SAP组患者（P < 0.05）；AMI组和UAP组患者HbA1c、IMT两指标比较，差异无统计学意义（P > 0.05）。CHD患者HbA1c水平与冠状动脉狭窄程度呈正相关（r = 0.516，P < 0.05）。结论 HbA1c可独立预测冠状动脉病变程度，并进一步促进动脉粥样硬化的发展，HbA1c在冠状动脉粥样硬化发生及发展中起重要作用，监测其水平变化对于CHD的诊断、病情判断及预后评估均有重要意义。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	冯月英盛净▲ 曹国良戴蓉芳

关键词 ：冠心病, 急性心肌梗死, 不稳定型心绞痛, 颈动脉内膜-中层厚度, 糖化血红蛋白

Abstract：Objective To explore the significance of glycosylated hemoglobin (HbA1c) in the occurrence and development of atherosclerosis. Methods Totally 120 patients with coronary heart disease, including 40 patients with acute myocardial infarction (AMI group), 40 patients with unstable angina (UAP group) and 40 patients with stable angina (SAP group), were enrolled in Shanghai Ninth People′s Hospital, Shanghai Jiaotong University School of Medicine from January 2015 to December 2016, and compared with those of 40 healthy subjects in the control group, grouped by the results of selective coronary angiography. Color Doppler ultrasound diasonograph was used to detect carotid intima media thickness (IMT). Digital subtraction angiography was used to perform the selective coronary angiography, and Gensini coronary disease score method was used to evaluate the severity of the coronary artery lesion. Enzymic method was used to detect the level of glycosylated hemoglobin and blood lipid. Results The levels of HbA1c and IMT in AMI group, UAP group and SAP group were significantly higher than those in control group (P < 0.01), and the levels of HbA1c in AMI group and UAP group were significantly higher than those in the SAP group (P < 0.01). IMT in AMI group and UAP group were significantly higher than those in the SAP group (P < 0.05). Both the levels of HbA1c and IMT had no significant difference between AMI group and UAP group (P > 0.05). The correlation between the level of HbA1c and the degree of coronary artery stenosis was positive in patients with coronary heart disease (r = 0.516, P < 0.05). Conclusion The level of HbAlc is independently associated with the severity of the coronary stenosis, and further accelerates the development of atherosclerosis. HbA1c plays an important role in the occurrence and development of coronary atherosclerosis. By Monitoring the level change of HbA1c, there will be important significance to the condition judgment and prognosis evaluation in patients with coronary heart disease.

Key words： Coronary heart disease Acute myocardial infarction Unstable angina Carotid intima media thickness Glycosylated hemoglobin

基金资助:上海市宝山区科委项目（10-E-1）。

通讯作者: ▲通讯作者

引用本文:

冯月英盛净▲ 曹国良戴蓉芳. 糖化血红蛋白在动脉粥样硬化发病机制中的作用研究[J]. 中国医药导报, 2018, 15(22): 85-87,95.
FENG Yueying SHENG Jing▲ CAO Guoliang DAI Rongfang. Study on the effect of glycosylated hemoglobin in the pathogenesis of atherosclerosis. 中国医药导报, 2018, 15(22): 85-87,95.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I22/85

[1] 原杰，张红霞，王丽佳，等.代谢综合征合并冠状动脉粥样硬化性心脏病患者心包周围脂肪体积与冠状动脉病变严重程度的相关性[J].中华健康管理学杂志，2014，8（3）：155-159.
[2] Ma J，Wang X，Wang Y，et al. The relationship between glycated hemoglobin and complexity of coronary artery lesions among older patients with diabetes mellitus [J]. PLoS One，2014，9（3）：e91 972.
[3] Piveta VM，Bittencourt CS，Oliveira CS，et al. Individuals with prediabetes identified by HbA1c undergoing coronary angiography have worse cardiometabolic profile than those identified by fasting glucose [J]. Diabetol Metab Syndr，2014，6（12）：138.
[4] 李晖，李明霞，张源明，等.血清25羟维生素D3与冠状动脉狭窄程度相关性研究[J].中华实用诊断与治疗杂志，2015，29（6）：565-567.
[5] Rasmussen-Torvik LJ，Li M，Kao WH，et al. Association of a fasting glucose genetic risk score with subclinical Atherosclerosis [J]. Diabetes，2011，60（1）：33l-335.
[6] Vasudevan，Abu R，Vivian A. The effectiveness of intensive glycemic control for the prevention of vascular complications in diabetes mellitus [J]. Treat Endocrinol，2006， 5（5）：273-286.
[7] 中国高血压防治指南修订委员会.2004年中国高血压防治指南（实用本）[J].中华心血管病杂志，2004，32（12）：1060-1064.
[8] Mailer HJ，Nielsen MJ，Maniecki MB，et al. Soluble mac-rophage-derived CD163：a homogenous ectodomain protein with a dissociable haptoglobin-hemoglobin binding [J]. Immunobiology，2010，215（5）：406-412.
[9] Nemet I，Turk Z，Duvnjak L，et al. Humoral methylglyoxal level reflects glycemic fluctuation [J]. Clin Biochem，2005， 38（4）：379-383.
[10] Selvin E，Steffes MW，Zhu H，et al. Glycated hemoglobin diabetes and cardiovascular risk in nondiabetic adults [J]. N Engl J Med，2010，362（9）：800-811.
[11] Gong Z，Xing S，Zheng F，et al. Increased expression of macrophage migration inhibitory factor in aorta of patients with coronary atherosclerosis [J]. Cardiovasc Surg（Torino），2015，56（4）：631-637.
[12] 弓露甲，赵开封，董建义，等.糖化血红蛋白水平与冠状动脉疾病的相关性研究[J].世界最新医学信息文摘，2016，16（59）：102-103.
[13] 王婧，汤成春.糖化血红蛋白A1c水平与冠心病的相关性研究进展[J].东南大学学报，2014，33（2）：238-242.
[14] Bonomo V，Piraino D，Bracale UM，et al. An evaluation of coronary atherosclerosis using coronary CT in subjects with asymptomatic carotid lesions [J]. Transl Med UniSa，2014，10（4）：22-28.
[15] Eeg-Olofsson K，Cederholm J，Nilsson PM，et al. New aspects of HbA1c as a risk factor for cardiovascular diseases in type 2 diabetes：an observational study from the Swedish National Diabetes Register（NDR） [J]. J Intern Med，2010，268（5）：471-482.
[16] 陶寿淇.我国血脂异常治疗现状的调查[J].中华心血管病杂志，2001，29（1）：15-17.
[17] Akosah KO，McHugh VL，Barnhart SI，et al. Carotid ultrasound for risk clarification in young to middle-aged adults undergoing elective coronary angiography [J]. Am J Hypertens，2006，19（12）：1256-1261.
[18] Brook RD，Bard RL，Patel S，et al. A negative carotid plaque area test is superior to other noninvasive atherosclerosis studies for reducing the likelihood of having underlying significant coronary artery disease [J]. Arterioscler Thromb Vasc Biol，2006，26（3）：656-662.
[19] O′Leary DH，Polak JF，Kronmal RA，et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults [J]. N Engl J Med，1999，340（1）：14-22.
[20] Slevin E，Marinopoulos，berkenbilit G，et al. Meta-analysis：Glycoylated hemoglobin and cardiovascular disease in diabetes mellitus [J]. Ann Inter Med，2004，141（6）：421-431.