果糖注射液对血糖及胰岛素的影响

48例T2DM病人随机分为果糖注射组（24例）和生理盐水（24例），每日分别给予500ML5％果糖注射液或生理盐水，3小时输液。于输液第0h、1．5h、3h测定静脉血糖和胰岛素水平；0h和3h测定血尿酸水平。结果：两组输液过程中各输液时点的血糖、胰岛素及尿酸的差异均无统计学意义。结论：与生理盐水比较，果糖注射液对T2DM患者血糖、胰岛素及血尿酸水平均无明显影响。     

果糖注射液对血糖及胰岛素的影响

48例T2DM病人随机分为果糖注射组（24例）和生理盐水（24例），每日分别给予500ML5％果糖注射液或生理盐水，3小时输液。于输液第0h、1．5h、3h测定静脉血糖和胰岛素水平；0h和3h测定血尿酸水平。结果：两组输液过程中各输液时点的血糖、胰岛素及尿酸的差异均无统计学意义。结论：与生理盐水比较，果糖注射液对T2DM患者血糖、胰岛素及血尿酸水平均无明显影响。     

果糖氯化钠注射液对糖尿病患者血糖的影响

120例T2DM病人随机分为果糖组（60例）和盐水组（60例），每日分别给予250ml果糖氯化钠注射液或生理盐水，1．5小时输入。于输液第Oh、1．5h测定静脉血糖水平。结果两组的血糖的差异无统计学意义。结论与生理盐水比较，果糖氯化钠注射液对糖尿病血糖无明显影响。     

转化糖电解质注射液对择期手术患者血糖及电解质的影响

目的观察转化糖电解质注射液对择期手术患者血糖、电解质的影响。方法 60例择期手术患者,随机分为A、B组,各30例。A组患者入室后开通外周静脉通道即开始输注10%转化糖电解质注射液250 ml,B组输注10%葡萄糖注射液250 ml。观察输液完毕后5 min（T1）及1（T2）、2（T3）h时患者血糖、电解质及血尿酸水平变化,并与输液前基础值（T0）比较。记录两组患者不良反应发生情况。结果输液后两组患者血糖浓度均显著上升,A组血糖水平波动小于B组。输液后A组血K＋显著下降（P〈0.01）,B组血K^＋无明显变化（P〈0.01）;两组血Na^＋、Cl^-均显著下降（P〈0.01）,A组T2、T3时血Ca^2＋水平较T0时下降（P〈0.05）,B组各时点血Ca^2＋水平无明显变化（P〉0.05）,组间比较P均〉0.05。输液后两组患者血尿酸水平无明显变化（P〉0.05）。输液中A组有18例（60%）、B组有2例（6.7%）输注部位疼痛不适（P〈0.01）。两组均无过敏反应发生。结论 10%转化糖电解质注射液对择期手术患者血糖的影响较10%葡萄糖注射液小。对于择期手术术前禁食患者及应激性血糖升高的手术后患者,更适宜输注转化糖电解质注射液。     

甘精胰岛素对2型糖尿病患者血糖波动幅度的影响

目的 观察甘精胰岛素对2型糖尿病（T2DM）患者血糖水平、24h波动幅度的影响及安全性。方法将同期收治的50例T2DM患者随机分为观察组和对照组各25例,分别采用甘精胰岛素及中性低精蛋白锌人胰岛素作为基础治疗药物。治疗前及治疗达标（空腹血糖〈7．0mmol／L）后第2天检测患者空腹、三餐后2h和睡前血糖,计算24h血糖标准差、极差（血糖最高值和最低值之差）,记录低血糖发生情况。结果两组治疗后24h血糖标准差和极差均显著低于治疗前,且观察组显著低于对照组（P均〈0．001）;两组低血糖发生率无显著差异。结论 甘精胰岛素可降低T2DM患者血糖水平及24h血糖波动幅度,且安全性高。     

阻塞性睡眠呼吸暂停综合征与2型糖尿病的关系

目的 探讨阻塞性睡眠呼吸暂停综合征（OSAS）与2型糖尿病（T2DM）的关系.方法 选择OSAS患者128例（观察组）,根据其睡眠呼吸紊乱程度分为轻、中、重度3组;另选80例呼吸道感染患者作为对照组,检测各组空腹血糖、餐后2h血糖、血浆胰岛素、餐后2h胰岛素.结果 观察组血糖与胰岛素水平均明显高于对照组（P均＜0.01）,其中17例确诊为T2DM;OSAS患者的睡眠呼吸紊乱程度越重,其血糖及胰岛素升高越明显（P＜0.01）.结论 OSAS可导致糖代谢异常,引发T2DM,其睡眠呼吸紊乱程度与糖代谢紊乱、高胰岛素血症水平明显相关,早期治疗OSAS对T2DM防治有重要临床价值.     

动态血糖监测甘精胰岛素治疗老年2型糖尿病的研究

目的通过动态血糖监测（CGMS），评估甘精胰岛素治疗老年2型糖尿病（T2DM）的疗效和安全性。方法对39例口服药联合治疗空腹血糖控制不佳的老年T2DM患者，加用甘精胰岛素（IG）和中性鱼精蛋白锌胰岛素（NPH）睡前皮下注射，治疗12周。治疗前后测定空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbAlc）、空腹C肽及餐后2hC肽等，并进行比较。结果治疗后，2组血糖和HbAlc均较治疗前下降（P〈0．05或P〈0．01），IG组血糖下降更明显（P〈0．05），2组HbAlc无明显差异（P〉0．05），IG组治疗后餐后2hC肽水平提高（P〈0．05）。CGMS显示IG组24h血糖曲线平缓，血糖达标时间延长，夜间低血糖的发生率低（P〈0．01）．血糖波动幅度小。结论IG作为老年T2DM患者的基础胰岛素替代治疗，血糖控制达标率高，胰岛素剂量控制更方便、安全，优于NPH。     

老年糖尿病患者胰岛素抵抗对内皮细胞功能的影响

目的 探讨老年2型糖尿病（T2DM）患者胰岛素抵抗（IR）对内皮细胞（EC）功能损伤的影响。方法 选择43例对照组（N组）、33例老年T2DM正常体重组（A1组）、43例老年T2DM超重组（A2组）、27例老年T2DM肥胖组（A3组）患者。测定空腹血糖（FBG），餐后2h血糖（PBG）、空腹胰岛素（FINS）、餐后2h胰岛素（PINS）、血浆一氧化氮（NO）等参数，测量身高、体重，计算体重指数（BMI）、应用稳态模式IR指数（HOMA-IR）作为IR指标，并对各组的这些指标进行对比分析。结果 与N组比较，DM各组的FBG、PBG、FINS均明显增高（P〈0．01），A1组A2组A3组，HOMA-IR逐渐增高，NO逐渐下降，经直线相关分析，A1组无相关性；A2组呈负相关（r=-0．4567，P〈0．05）；A3组呈显著负相关（r=0．5647，P〈0．01）。结论 老年DM患者存在着血管内皮功能的损害，高血糖及IR均为重要原因之一，但损伤机制可能完全不相同。     

诺和锐联合甘精胰岛素强化治疗老年2型糖尿病疗效观察

目的：观察诺和锐联合甘精胰岛素治疗老年2型糖尿病（ T2DM）的疗效。方法将140例老年T2DM患者按照随机数字表法分为治疗组和对照组各70例,治疗组给予诺和锐联合甘精胰岛素,对照组给予阿卡波糖与诺和锐。结果两组治疗前FPG、1 h PG、2 h PG、3 h PG、HbA1C、TC、TG比较,P均＞0．05;两组治疗后上述指标比治疗前降低（P均＜0．05）,且治疗组较对照组降低更明显（P均＜0．05）。治疗组血糖达标时间（2．73±0．27）d、低血糖发生率18．6％（13/70）,对照组分别为（3．19±0．31）d、7．1％（5/70）,P均＜0．05。结论诺和锐联合甘精胰岛素治疗老年T2 DM可有效降低血糖、血脂水平,缩短血糖达标时间,且低血糖发生率低。     

门冬胰岛素与人胰岛素对妊娠合并糖代谢异常患者的有效性及安全性

目的分析对比门冬胰岛素与人胰岛素对妊娠合并糖代谢异常患者的有效性及安全性及其对妊娠结局的影响。方法将2004年1月1日至2010年5月31日接受孕期检查并分娩的应用门冬胰岛素控制血糖的妊娠合并糖代谢异常者纳入分析（Asp组，n=77），其中妊娠合并糖尿病（DM）患者22例、妊娠期糖尿病（GDM）患者55例。选择同期接受孕期检查并分娩的应用人胰岛素控制血糖的妊娠合并糖代谢异常患者（HI组，n=77）按1：1作为对照进行回顾性对比研究。对比2组胰岛素治疗前后血糖变化、血糖下降至正常水平所需时间、胰岛素最大用量、治疗期间低血糖事件发生率及分娩结局。2组数据比较用t检验及秩和检验。结果治疗1周后，Asp组DM患者早餐、晚餐后2h血糖分别为（6．5±1．1）和（7．1±1．1）mmol／L，HI组则分别为（8．0±1．1）和（7．8±0．8）mmol／L；而Asp组GDM患者早餐、午餐和晚餐后2h血糖分别为（6．5±0．7）、（6．8±0．7）和（6．7±0．7）mmol／L，HI组则分别为（7．1±0．9）、（7．3±0．9）和（7．4±0．8）mmol／L；Asp组餐后2h血糖水平均低于Ⅲ组，差异均有统计学意义（均P〈0．05）。Asp组DM患者早餐后2h血糖首次下降至正常水平所需时间为（3．0±2．2）d，HI组则为（5．0±2．1）d；Asp组GDM患者早餐后2h血糖首次下降至正常水平所需时间为（2．3±1．6）d，HI组则为（4．3±2．6）d；Asp组餐后血糖下降至正常水平所需时间均比HI组短，差异均有统计学意义（均P〈0．05）。Asp组低血糖事件发生率为3．9％（DM患者1例，GDM患者2例），HI组为24．7％（DM患者8例，GDM患者11例）（P〈0．05）。Asp组DM患者新生儿低血糖发生率及新生儿转儿科率分别为4．5％、36．4％，而HI组为18．2％、50．0％；Asp组GDM患者巨大儿、新生儿低血糖发生率及转儿科率分别为10．9％、3．6％、25．5％，HI组则分别为18．2％、10．9％、38．2％；Asp组的分娩结局有优于HI组的趋势，但2组间差异均无统计学意义（均P〉0．05）。结论在妊娠合并糖代谢异常孕妇中，相比人胰岛素，门冬胰岛素能更快、更有效地控制血糖，同时可明显降低低血糖事件的发生。对分娩结局的影响方面，Asp组有优于Ⅲ组的趋势。     

2型糖尿病合并高尿酸血症患者动脉粥样硬化的影响因素

目的研究2型糖尿病合并高尿酸血症(HUADM)患者颈动脉内膜中层厚度(IMT)与脂联素、C反应蛋白(CRP)的关系。方法选择2型糖尿病患者85例,按血尿酸水平分为:HUADM组43例、血尿酸正常糖尿病(NUADM)组42例,分析2组空腹血糖(FPG)、空腹胰岛素(FINS)、脂联素、CRP、糖化血红蛋白(HbA1c)及餐后2h血糖、餐后2h胰岛素,IMT,计算胰岛素抵抗指数(HOMA-IR),并且进行多元逐步回归分析。结果与NUADM组比较,HUADM组患者FPG、餐后2h血糖、FINS、餐后2h胰岛素、HbA1c、IMT、尿酸和lgHOMA-IR均明显升高,脂联素明显降低(P0.05,P0.01)。HUADM组患者IMT与HOMA-IR、TG、LDL-C和CRP呈正相关,与脂联素呈负相关。结论 HUADM患者存在更明显的代谢紊乱和胰岛素抵抗,且血清脂联素水平降低,CRP水平升高,提示更容易发生动脉粥样硬化。     

代谢性高血压的临床特点研究

检测62例高血压病(EH)中单纯EH(EH-1,n=23),伴高胰岛素血症(HIS)和糖耐量异常(IGT)的EH(EH-2,n=15)、伴HIS的EH(EH-3,n=21)和对照组(NS,n-24)糖耐量中血糖(SG)、胰岛素(IS)、C肽(CP)及其克分子比值、IS敏感性指数(ISI)等,发现:①服糖后1小时、2小时SG各时间点的IS、CP及其面积,EH-2、EH-3组明显高于EH-1和NS组(P<0.05);②ISI、服糖后CP/IS比值,EH-2、EH-3组明显低于EH-1和NS组(P<0.05);③EH-2和EH-3两组(即代谢性高血压,MH)中肥胖者50%与EH 1组中肥胖者39.13%无明显统计学差异(P>0.05);④甘油三酯、尿酸、高密度脂蛋白、体重指数等在MH与EH-1组之间未见明显差异(P>0.05).提示,EH中存在一类MH,按其临床特点包括EH-2、EH-3两组;EH中肥胖与MH之间似无直接联系;MH似无明显的高甘油三酯、高尿酸、低HDL-C和肥胖等典型表现,临床主要应按有否HIS及其ISI值来判断是否MH.     

A comparison of the activity and disposal of semi-synthetic human insulin and porcine insulin in normal man by the glucose clamp technique

Summary The activity of semi-synthetic human insulin has been compared with porcine insulin in normal man using an euglycaemic glucose clamp at two different insulin infusion rates. In a two hour infusion insulin levels plateaued for both types of insulin at 44–48 mU/l (infusion rate 0.05 U kg body weight^-1 h^-1) and 22–24 mU/l (0.02 U kg^-1 h^-1), giving identical metabolic clearance rates. The glucose delivery required to maintain euglycaemia in the second hour of insulin infusion was 13.9±2.1 g (mean±SEM) and 14.7±1.5 g (NS) at the lower dose for porcine and human insulins respectively, and 27.1±2.5 and 28.0±2.9 g (NS) at the higher dose. The potency ratio for human, compared with porcine, insulin was 1.06 ±0.12. No differences were seen in the time of onset of action of the insulins, serum half-life or distribution space. The responses of blood lactate, pyruvate, alanine, glycerol and 3-hydroxybutyrate were identical. No untoward reactions occurred. The activity and disposal of this semi-synthetic human insulin are indistinguishable from porcine insulin in normal euglycaemic man.     

Effects of carbohydrates on uric acid metabolism

The rapid infusion of fructose, but not of glucose or galactose, to normal male volunteers produced a 30% rise in serum uric acid. All three hexoses increased the renal excretion of uric acid, phosphate, bicarbonate, and glucose. While only fructose clearly increased uric acid production, all three hexoses appeared to diffusely inhibit renal proximal tubular function. Data are presented that suggest that fructose infusions may concomitantly stimulate the conversion of preformed adenine nucleotides to uric acid while inhibiting de novo uric acid synthesis. Chronic ingestion of a fructose-rich diet did not alter serum or urinary uric acid.     

血尿酸和细胞间黏附分子1对2型糖尿病颈动脉内膜中层厚度的影响

目的探讨2型糖尿病合并颈动脉粥样硬化(CA)患者血尿酸、细胞间黏附分子1(ICAM-1)与颈动脉内膜中层厚度(IMT)的关系。方法选择2型糖尿病患者80例,根据诊断分为糖尿病合并颈动脉粥样硬化组(CA组)40例和单纯糖尿病组(对照组)40例,检测分析2组患者血尿酸、ICAM-1、收缩压、舒张压、空腹血糖、空腹胰岛素、糖化血红蛋白、餐后2 h血糖、餐后2 h胰岛素、HDL-C、LDL-C、TC、TG等糖、脂代谢指标及颈动脉IMT的水平差异。同时计算体重指数、胰岛素抵抗指数(HOMA-IR)。结果 CA组颈动脉IMT、血尿酸、ICAM-1、收缩压、体重指数、TG、TC、LDL-C、糖化血红蛋白、空腹血糖、餐后2 h血糖、空腹胰岛素、餐后2 h胰岛素、HOMA-IR均明显高于对照组(P<0.05,P<0.01)。血尿酸、ICAM-1与颈动脉IMT密切相关(P<0.01),作为CA的主要独立影响因素最先进入多元逐步回归方程。结论 2型糖尿病合并CA患者较无CA的糖尿病患者存在更明显的代谢紊乱、胰岛素抵抗、血管内皮功能障碍及炎性反应,早期联合检测血尿酸、ICAM-1有助于对糖尿病人群发生血管病变进行预测。     

Insulin-dependent regulation of insulin-like growth factor-binding protein-1.

In previous studies it has been determined that food ingestion or glucose infusion suppresses serum insulin-like growth factor-binding protein-1 (IGFBP-1) concentrations in normal subjects. It has not been determined, however, whether glucose-dependent suppression is due to enhancement of insulin-stimulated glucose transport, to some other insulin-mediated effect, or to a direct effect of glucose. These studies were undertaken to determine if infusion of other nutrients or energy sources that activate glycolysis, but not insulin secretion, could lead to suppression of the plasma concentrations of this protein. After infusion of 50 g glucose over 4 h, the mean plasma IGFBP-1 concentration fell from 44.3 +/- 13.8 to 17.4 +/- 8.1 micrograms/L (P less than 0.001). In contrast, when 50 g fructose were infused over 4 h, IGFBP-1 decreased from 44.6 +/- 7.4 to only 32.7 +/- 6.7 micrograms/L (P less than 0.01). Comparison of these changes showed that the mean decrease after glucose infusion was significantly greater than that after fructose (P less than 0.01). In contrast to these decreases, infusion of an isocaloric amount of triglycerides resulted in no significant change in IGFBP-1 concentrations (from 49.8 +/- 14.1 to 40.2 + 10.4 micrograms/L; P = NS). Concomitant measurements of immunoreactive C-peptide during the glucose and fructose infusions showed that plasma C-peptide levels rose from 1.6 +/- 0.2 to 3.9 +/- 0.7 nM (P less than 0.001) during the glucose infusion, whereas the maximum increase was from 1.7 +/- 0.4 to only 2.3 +/- 0.4 nM (P less than 0.05) during the fructose infusion. The difference between these mean changes was also significant. The change in C-peptide correlated inversely with the changes in IGFBP-1 during the glucose infusion (r = -0.68); P less than 0.001), but not during fructose infusion (r = -0.31). The results of this study suggest that insulin stimulation of cellular metabolic pathways is an important variable regulating the suppression of plasma IGFBP-1 concentrations. Activation of noninsulin-dependent glycolytic pathways appears to result in an equivalent degree of suppression, whereas provision of other energy substrates has no effect. We conclude that both insulin and glucose are important regulators of plasma concentrations of IGFBP-1 in vivo, and in this way they may significantly influence IGF action.     

体育运动对轻度高血压病患者血胰岛素的影响

目的探讨体育运动对高血压病患者血胰岛素的影响。方法将１０９例轻度原发性高血压病患者随机分配到运动组（５３例）和对照组（５６例）。两组均接受尼群地平降压治疗，同时对运动组进行为期３个月的中等强度运动干预。测量两组入选时和３个月后血压、空腹血糖、血胰岛素、血脂及口服葡萄糖负荷后１、２小时血糖及胰岛素。结果经过３个月规则运动，运动组空腹及糖负荷后１、２小时胰岛素水平低于对照组（Ｐ值均＜００５），其空腹胰岛素下降程度与运动量呈正相关（ｒ＝０６１，Ｐ＜００５），血胆固醇、甘油三酯及低密度脂蛋白水平低于对照组（Ｐ＜００５）。结论长期中等强度的体育运动能降低高血压病患者空腹及糖负荷后血胰岛素水平，并有利于纠正血脂代谢紊乱。     

Gender differences in the relationships of serum uric acid with fasting serum insulin and plasma glucose in patients without diabetes

OBJECTIVE: To explore gender differences in the relationship of serum uric acid levels with fasting serum insulin and fasting plasma glucose concentrations among an adult Chinese nondiabetic population in Kinmen, Taiwan. METHODS: A total of 7,483 nondiabetic subjects (4,265 women, 3,218 men, aged 30 to 89 years) were involved in a community based epidemiologic study. Those with known or newly diagnosed diabetes were excluded. Overnight fasting blood samples were drawn for serum uric acid, glucose, insulin, lipid, and other biochemical measurements. Demographic and clinical variables including body mass index (weight/height2), waist-to-hip ratio, and blood pressure were measured and documented during face-to-face interviews with structured questionnaires. RESULTS: Stratified analyses revealed that (1) serum uric acid levels were positively associated with hyperinsulinemia and HOMA-insulin resistance in both men and women after adjusting for hypertriglyceridemia, hypertension, obesity, and plasma glucose levels; and (2) serum uric acid levels were more strongly associated with hyperinsulinemia and plasma glucose levels in women than in men. CONCLUSION; Hyperuricemia was positively associated with hyperinsulinemia among patients of both sexes without diabetes. Elevated levels of uric acid should alert physicians to the possibility of insulin resistance. The serum uric acid level was associated with insulin resistance and plasma glucose levels more strongly in females than in males in our study population.     

Chronic physiologic hyperinsulinemia impairs suppression of plasma free fatty acids and increases de novo lipogenesis but does not cause dyslipidemia in conscious normal rats

Type 2 diabetes mellitus and obesity are characterized by fasting hyperinsulinemia, insulin resistance with respect to glucose metabolism, elevated plasma free fatty acid (FFA) levels, hypertriglyceridemia, and decreased high-density lipoprotein (HDL) cholesterol. An association between hyperinsulinemia and dyslipidemia has been suggested, but the causality of the relationship remains uncertain. Therefore, we infused eight 12-week-old male catheterized conscious normal rats with insulin (1 mU/min) for 7 days while maintaining euglycemia using a modification of the glucose clamp technique. Control rats (n = 8) received vehicle infusion. Baseline FFAs were 1.07+/-0.13 mmol/L, decreased to 0.57+/-0.10 (P < .05) upon initiation of the insulin infusion, and gradually increased to 0.95+/-0.12 by day 7 (P = NS vbaseline). On day 7 after a 6-hour fast, plasma insulin, glucose, and FFA levels in control and chronically hyperinsulinemic rats were 32+/-5 versus 116+/-21 mU/L (P < .005), 122+/-4 versus 129+/-8 mg/dL (P = NS), and 1.13+/-0.18 versus 0.95+/-0.12 mmol/L (P = NS); total plasma triglyceride and cholesterol levels were 78+/-7 versus 66+/-9 mg/dL (P = NS) and 50+/-3 versus 47+/-2 mg/dL (P = NS), respectively. Very-low-density lipoprotein (VLDL) + intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL), and HDL2 and HDL3 subfractions of plasma triglyceride and cholesterol were similar in control and hyperinsulinemic rats. Plasma FFA correlated positively with total (r = .61, P < .005) triglycerides. On day 7 after an 8-hour fast, hyperinsulinemic-euglycemic clamps with 3-3H-glucose infusion were performed in all rats. Chronically hyperinsulinemic rats showed peripheral insulin resistance (glucose uptake, 15.8+/-0.8 v 19.3+/-1.4 mg/kg x min, P < .02) but normal suppression of hepatic glucose production (HGP) compared with control rats (4.3+/-1.0 v 5.6+/-1.4 mg/kg x min, P = NS). De novo tissue lipogenesis (3-3H-glucose incorporation into lipids) was increased in chronically hyperinsulinemic versus control rats (0.90+/-0.10 v 0.44+/-0.08 mg/kg x min, P < .005). In conclusion, chronic physiologic hyperinsulinemia (1) causes insulin resistance with regard to the suppression of plasma FFA levels and increases lipogenesis; (2) induces peripheral but not hepatic insulin resistance with respect to glucose metabolism; and (3) does not cause an elevation in VLDL-triglyceride or a reduction in HDL-cholesterol.     

老年糖耐量减退患者血尿酸水平与冠心病相关性研究

目的探讨老年糖耐量减退患者血尿酸水平与冠心病的关系。方法选取糖耐量减退患者118例,根据冠状动脉造影结果分为单纯糖耐量减退组(51例)及糖耐量减退合并冠心病组(67例),测定两组患者的血尿酸、血脂等生化指标,分析血尿酸水平与糖耐量减退合并冠心病的相关性。结果糖耐量减退合并冠心病组血尿酸水平为(354.92±51.27)μmol/L,单纯糖耐量减退组血尿酸水平为(323.57±48.66)μmol/L,两组比较差异有统计学意义(P<0.01),其中单支、双支、三支病变患者血尿酸水平分别为(330.92±53.65)μmol/L(、347.25±56.17)μmol/L、(362.93±54.21)μmol/L,各组间比较差异无统计学意义(P>0.05)。血尿酸水平与冠状动脉病变程度呈正相关(r=0.24,P<0.05)。结论老年糖耐量减退合并冠心病患者冠状动脉病变程度与血尿酸相关,测定血尿酸水平可对此类患者冠状动脉病变程度提供参考依据。