非糖尿病冠心病患者糖化血红蛋白与颈动脉病变相关性分析

目的探讨非糖尿病冠心病患者糖化血红蛋白（HbA1c）水平与颈动脉病变的相关性。方法选择经冠脉造影明确诊断冠心病的非糖尿病患者275例,按照HbA1c水平以三分位法分为低水平组（HbA1c≤5.6%,n=103例）,中水平组（HbA1c：5.6%-5.9%,n=93例）,高水平组（HbA1c〉5.9%,n=79例）。颈动脉超声测定颈总动脉内膜中膜厚度（IMT）,分为正常对照组（IMT≤0.9mm）,轻度增厚组（IMT0.9mm-1.2mm）,明显增厚组或斑块形成组（IMT〉1.2mm）。分析HbA1c水平与颈动脉病变的相关性。结果 HbA1c高水平组中IMT〉1.2mm者共56例,占70.9%,比例大于中水平组（64例,占68.8%）,大于低水平组（67例,占65%）,但无统计学意义。经Pearson相关分析及偏相关分析,校正年龄、性别、吸烟状况、饮酒状况、心梗史、病变支数、空腹血糖、尿酸、甘油三酯、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、高敏C反应蛋白、BMI（体重指数）等因素后,HbA1c水平与颈动脉内中膜及斑块厚度无显著关系。结论在非糖尿病的冠心病人群中,HbA1c水平与颈动脉内中膜及斑块厚度无明显相关性。

The relation of glycosylated hemoglobin level with carotid artery lesion in non-diabetic coronary heart disease individuals

Objective To examine the relation between HbA1c level and carotid artery lesion in non-diabetic coronary heart disease individuals. Methods 275 nondiabetic patients who diagnosised CHD by coronary angiography were enrolled with glycosylated hemoglobin level to low level group（HbA1c ≤ 5.6%,n=103）,middle level group（HbA1c： 5.6%-5.9%,n=93）,and high level group（HbA1c 5.9%,n=79）. Carotid intima—media thickness（IMT） was determined by carotid ultrasound, and divided into normal carotid artery（IMT ≤ 0.9mm）,mild increased carotid artery（IMT O.9mm- 1.2mm）,apparent increased carotid artery or occurrence of carotid plaque （IMT1.2 mm）.Then analyze the association between HbA1c level and carotid artery lesion. Results The number of people with IMT1.2 mm in high level group is 56（70.9%）,the proportion greater than middle level group（n=64, 68.8%） , greater than low level group（n=67,65%）, but did not reach statistical signif icance. Analyzed by Pearson correlation analysis and meta- correlation analysis,corrected to age、 sex、smoking、drinking、the history of myocardial infarction、coronary artery lesion branch、fasting serum glucose、UA、TG、TC、HDL-C、LDL-C、 HSCRP、BMI,HbA1c level had no conspicuous relationship with Carotid intima—media and carotid plaque thickness.Conclusions HbA1c has no obvious correlation with Carotid intima—media and carotid plaque thickness in non—diabetic CHD individuals.