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目的:探讨血糖正常人群中血清糖化血红蛋白(HbA1c)与冠脉粥样硬化的关系。方法:选择行冠脉CT血管(CTA)成像的血糖正常者184例,根据空腹血糖水平和CTA结果分组,比较各组间血清HbA1c含量和冠脉Gensini积分以及不同水平血糖组冠脉粥样硬化程度的差异。分析血清HbA1c含量与冠脉Gensini积分的相关性。结果:冠脉粥样硬化轻度病变组和重度病变组中,血糖正常者血清HbA1c含量均低于血糖正常高限者,差异均有统计学差异(P<0.05)。血糖正常和血糖正常高限者中,不同冠脉粥样硬化程度者之间Gensini积分差异均有统计学意义(P<0.05);在冠脉粥样硬化重度病变组中血糖正常者的Gensini积分(47.21±3.69)低于血糖正常高限者(52.25±3.82),差异有统计学差异(P<0.05)。血糖正常组无冠脉粥样硬化的比例(51.72%)显著高于血糖正常高限组(39.68%),经秩和检验,血糖正常组和血糖正常高限组的冠脉粥样硬化程度比较,差异有统计学意义(P<0.05)。血清HbA1c含量与冠脉Gensini积分呈正相关(r=0.384,P<0.001)。结论:正常血糖人群中血清HbA1c与冠脉粥样硬化程度呈正相关,HbA1c可能参与了冠脉粥样硬化的发生发展过程。
Objective: To investigate the relationship between serum HbA1c and coronary atherosclerosis in normal people with blood glucose. Methods: One hundred and eighty-four patients with normal blood glucose level underwent CT coronary angiography (CTA) were enrolled. According to the fasting blood glucose level and CTA results, serum HbA1c levels, coronary Gensini scores and coronary atherosclerosis Difference in degree. The correlation between serum HbA1c level and coronary Gensini score was analyzed. Results: The serum levels of HbA1c in patients with mild coronary atherosclerosis and severe disease were lower than those with normal hyperglycemia, the difference was statistically significant (P <0.05). Gensini scores of patients with different degree of coronary atherosclerosis were significantly higher than those with normal blood glucose level and high blood sugar level (P <0.05); Gensini score of patients with normal blood sugar level in patients with severe coronary atherosclerosis (47.21 ± 3.69) lower than the normal high blood sugar (52.25 ± 3.82), the difference was statistically significant (P <0.05). The percentage of patients with normal blood sugar without coronary atherosclerosis (51.72%) was significantly higher than that with normal high blood glucose (39.68%). The rank of coronary atherosclerosis was higher in the patients with normal blood glucose and high blood glucose , The difference was statistically significant (P <0.05). Serum HbA1c levels were positively correlated with coronary Gensini scores (r = 0.384, P <0.001). Conclusion: There is a positive correlation between serum HbA1c and coronary atherosclerosis in normal blood glucose and HbA1c may be involved in the development of coronary atherosclerosis.