老年糖尿病血胱抑素-C与冠脉病变的相关性研究

摘要

目的 研究老年2型糖尿病病人血清胱抑素C(cystatin C,Cys-C)水平变化与冠状动脉病变程度的相关性. 方法 收集2013年10月至2015年11月在我院内分泌科及心内科住院的老年糖尿病病人120例,每例病人均行Flash双源CT冠状动脉检查(CCTA),抽血检测Cys-C、糖化血红蛋白(HbA1c)水平,根据CT冠状动脉检查(CCTA)结果将所有病人依冠脉狭窄程度分组为: 冠状动脉CTA结果正常组(DM1组),冠状动脉狭窄率≤50%组(DM2组),冠状动脉狭窄率50%~75%组(DM3组),冠状动脉狭窄率≥75%组(DM4组),比较各组间Cys-C及HbA1c的差异. 结果 4组间血Cys-C、HbA1c水平差异均具有统计学意义(P<0.05),各组间年龄、心率、血压比较均无统计学意义.血Cys-C水平与HbA1c成正相关. 结论 老年2型糖尿病病人血Cys-C水平随着冠状动脉狭窄程度的增加而升高,血Cys-C可能成为老年2型糖尿病发生冠脉病变的早期预测因子.老年DM冠脉病变及其严重程度与血Cys-C、HbA1c密切相关.%Objective To study the relationship between cystatin C(Cys-C) level and the development of coronary heart disease in elderly patients with type 2 diabetes.Methods 120 cases of elderly diabetic patients were enrolled in this study from October 2013 to December 2015 in Department of Endocrinology and Cardiology.All patients underwent the detection of routine Flash dual-source CT of coronary artery (CCTA), Cys-C, hemoglobin A1c (HbA1c).According to the difference of CCTA results, the patients were divided into DM1 group (with normal coronary CTA), DM2 group (with a coronary artery stenosis rate of 25% to 50%), DM3 group (with a coronary artery stenosis rate of 50% to 75%) and DM4 group (with a coronary artery stenosis rate of more than 75%).The levels of Cys-C and HbA1c were compared between the four groups.Results The blood levels of Cys-C, HbA1c showed significant differences between DM1, DM2, DM3, DM4 group(P<0.05).The age, heart rate, blood pressure showed no statistical differences between the groups.The level of Cys-C was positively correlated with HbA1c.Conclusions The blood level of Cys-C in the elderly patients with type 2 diabetes increases with the increase of the degree of coronary artery stenosis.Blood Cys-C may be used as an early predictor of coronary artery lesions in elderly patients with type 2 diabetes.