冠心病合并2型糖尿病患者糖化血红蛋白与冠状动脉复杂程度相关性研究

摘要

Objective:The aim of the study was to investigate the relationship between the glycated hemoglobin (HbA1 c) value and coronary artery lesion complexity in diabetic patients.Methods:A total of 537 patients with diabetes who diagnosed CAD were consecutively enrolled from January 2012 to June 2012.Finally,493 of these patients who met the inclusion and exclusion criteria were analyses.The subjects were divided into quartiles according to the HbA1 c values.The severity of coronary artery lesions was quantified with Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) score,which was calculated using the online calculator for SYNTAX score.Logistic regression analysis was used to predict the prevalence of an intermediate or high SXscore.Results:A total of 493 patients (352 women and 141 men) with a mean ages of (58.8 ±9.8) years were enrolled in this study.The higher HbAlc quartiles were significantly associated with a higher SX-score [n =493,Q1:(12.5 ±7.1),Q2:(16.0 ±7.0),Q3:(17.6 ±7.6),Q4:(22.3 ±6.6),P =0.001].In addition,a higher HbA1c quartiles independently predicted patients with intermediate or high SXscores (Odds ratio:Q1∶ 1.00 reference,Q2∶ 1.47,Q3∶ 1.96,Q4∶ 3.91).Conclusion:The HbA1c is significantly associated with the complexity of coronary lesions.A higher HbAlc value is an independent predictor of the prevalence of complex coronary lesions.%目的:探讨冠心病合并2型糖尿病患者糖化血红蛋白(HbA1c)与冠状动脉复杂程度相关性研究.方法:连续人选2012年1月至2012年6月,在我中心行冠状动脉造影诊断冠心病合并2型糖尿病患者共537例,根据纳入及排除标准,44例被排除,最终493例纳入该研究.依据入院时患者HbA1c水平,用四分位数将患者分为四组.冠状动脉病变的复杂程度用SYNTAX评分计算.采用Lo-gistic回归分析HbA1c与冠状动脉病变复杂程度之间的关系.结果:HbA1c四分位组(Q1 ～Q4)越高,冠状动脉SYNTAX评分越高,冠状动脉病变程度越复杂[Q1:(12.5±7.1)分,Q2:(16.0±7.0)分,Q3:(17.6±7.6)分,Q4:(22.3±6.6)分,P＜0.001].Logistic回归分析发现HbA1c四分位组越高,SYNTAX评分中高组的风险越高,调整年龄、性别、吸烟等相关因素后,高HbA1C分类Q2～ Q4相对Q1的OR分别为Q2∶1.47,Q3∶1.96,Q4∶3.91(P＜0.001).结论:糖化血红蛋白与冠状动脉复杂程度密切相关,是冠状动脉病变复杂程度的独立预测因子,有效的血糖管理可能会减轻冠状动脉血管病变复杂性.