急性冠状动脉综合征患者高敏C反应蛋白与糖化血红蛋白的相关性研究

摘要

目的 探讨急性冠状动脉综合征(ACS)患者血浆高敏C反应蛋白(hs-CRP)和糖化血红蛋白(HbA1c)水平与冠状动脉病变严重程度的关系及hs-CRP与HbA1c的相关性.方法 选择因ACS行冠状动脉造影术患者80例(ACS组),其中急性心肌梗死(AMI) 33例,不稳定型心绞痛(UA)47例.按病变支数分为单支病变组(27例),双支病变组(23例),三支病变组(30例).另选择因怀疑冠心病行冠状动脉造影术排除冠心病的患者32例作为对照组.以液相层析法检测HbA1c浓度,以乳胶免疫增强比浊法检测hs-CRP浓度.结果 ACS组和其中的单支、双支、3支病变组以及AMI组、UA组的hs-CRP水平均明显高于对照组[(7.85 ±5.89)、(4.49±2.68)、(8.79 ±5.09)、(9.37 ±5.49)、(10.93 ±4.56)、(4.89 ±2.09) mg/L比(1.56 ± 1.03) mg/L,均P＜0.01],HbA1c水平与对照组比较差异均无统计学意义[(6.48 ±1.32)％、(6.33 ± 1.60)％、(6.54 ± 1.68)％、(6.79 ± 1.32)％、(6.49 ± 1.46)％、(6.52 ± 1.32)％比(6.32 ± 1.20)％,均P＞0.05].hs-CRP与病变支数、病变类型呈正相关(r=0.63,r=0.74,均P＜0.01).HbA1c与病变支数和病变类型无相关性(r=0.09,r=0.06,均P＞0.05).结论 ACS患者中血浆hs-CRP水平升高,hs-CRP与冠状动脉病变不稳定程度具相关性.HbA1c不能反映冠状动脉病变的不稳定程度.ACS急性期hs-CRP与HbA1c无相关性,HbA1c与动脉粥样硬化斑块慢性进展、累及范围相关,hs-CRP更多反映动脉粥样斑块的不稳定状态.%Objective To explore the correlation between high sensitivity C-reactive protein (hs-CRP) and glycated hemoglobin A1 c(HbA1 c) in adult with acute coronary syndrome(ACS).Methods Coronary artery angiography(CAG) was done for all the subjects by Judkins'methods; 80 ACS patients were performed.The control group consisted of 32 subjects without CHD,including 6 diabetes.According to the severity of coronary artery stenosis,80 ACS patients were divided into three groups:single-artery lesions,doubie-artery lesions and multi-artery lesions; according to the type of ACS,80 patients were dinvided into unstable angina pectoris(UA) and acute myocardial infraction (AMI).The serum content of hs-CRP was measured by enhanced immunoturbidimetric assary (ITM).HbA1c was measured by liquid chromatography(LC) method.Results hs-CRP levels in all observation groups were significantly higher than those in the control group [(7.85 ± 5.89),(4.49 ± 2.68),(8.79 ± 5.09),(9.37 ± 5.49),(10.93 ± 4.56),(4.89 ± 2.09) mg/L vs (1.56 ± 1.03) rmg/L,all P ＜ 0.01].HbA1 c levels had no statistical significant difference compared with the control group [(6.48 ± 1.32) ％,(6.33 ± 1.60) ％,(6.54±1.68)％,(6.79±1.32)％,(6.49±1.46)％,(6.52±1.32)％ vs (6.32±1.20)％,allP＞0.05].hs-CRP were positively correlated with the lesion counts and the lesion types (r =0.63,r =0.74,P ＜ 0.01).HbA1c had no correlation with lesion counts and the lesion types (r =0.09,r =0.09,P ＞ 0.05).Conclusions In the coronary syndrome patients,the concentration of the hs-CRP increased and it is positively correlated with the unstable states of atherosclerotic plaque.But HbA1c has no correlation with unstable coronary atherosclerotic plaque.hs-CRP levels are not correlated with HbA1c's.HbA1c reflect chronic pathological process of atherosclerotic,but hs-CRP can be used as a factor detecting the unstable states of atherosclerotic plaque.