糖尿病合并冠心病患者C反应蛋白、糖化血红蛋白水平与心力衰竭的相关性研究

摘要

目的：探讨糖尿病合并冠心病患者C反应蛋白（CRP）、糖化血红蛋白（ HbA1C）水平与心力衰竭的相关性。方法选取我院2013年3月-2014年3月收治的糖尿病患者137例，根据患者冠状动脉造影将其分为单纯糖尿病患者65例（对照1组）及冠心病合并糖尿病尿病及心力衰竭患者72例（观察组），同时选取同期本院体检健康者50例作为对照2组。比较各组患者血浆HbA1C、CRP、血压（SBP、DBP）、左心室功能各指标（ESV、EDV、EF）、血脂指标（TC、TG、LDL-C、HDL-C）及血糖（FPG、2hPBG）水平。结果观察组及对照1组患者HbA1C、CRP、FPG、2hPBG、SBP、DBP、TC、TG、LDL-C、ESV、EDV水平明显高于对照2组，而HDL-C、EF明显低于对照2组，差异均有统计学意义（P＜0.05）；而观察组HbA1C、CRP、ESV、EDV水平高于对照1组，EF低于对照1组，差异均有统计学意义（P＜0.05）。经多因素Logsitic 回归分析可知， HbA1C、CRP是糖尿病合并冠心病并发心力衰竭的独立危险因素。结论 HbA1C、CRP可能是引起糖尿病合并冠心病患者发生心力衰竭的相关因素，通过监测HbA1C、CRP水平可以预测糖尿病合并冠心病患者心功能状况，预防心力衰竭的发生。%Objective To analyze the application effect of CRP,HbA1C and heart faiure in the patientswith DM and CHD. Methods 137 cases in our hospital from March 2013 to March 2014 with CHD were divided into two groups follow,And 65 cases in the control 1 group only with DM and 72 cases in the experimental group with heart faiure in the patientswith DM and CHD.And 50 Healthy persons in our hospital were selected as control 2 group.The data of three groups were compared,included HbA1C,CRP,blood presure(SBP,DBP), left ventricular functionindex (ESV,EDV,EF),blood fatindex(TC,TG,LDL-C,HDL-C)and blood glucose(FPG,2hPBG). Results The indexes (HbA1C,CRP,FPG,2hPBG,SBP,DBP,TC,TG、LDL - C,ESV,EDV)of all cases in experimental group and control 1 group were higher than control 2 group,butHDL-C、EF were lower than control 2 group(P < 0.05). The indexes (HbA1C,CRP,ESV,EDV)of all cases in experimental group were higher than control 1 group,butEF were lower than control 1 group(P < 0.05).Follow multiple Logistic regression analysis,HbA1C、CRP are independentprognostic factor of heart failure in patients with DM and CHD.Conclusion HbA1C,CRP maybe is the factor of heart faiure in the patientswith DM and CHD.HbA1C,CRP Can forecast dangerous of HCD.It Can be used to prognose the patient with CHF.