血清25OHVD水平在2型糖尿病及其并发的急性冠脉综合征中的变化和与血清CRP、MMP-9、HPA水平的相关性分析

目的探讨血清25羟基维生素D（250HVD）水平在2型糖尿病（T2DM）及其并发的急性冠脉综合征（ACS）患者中的变化情况及与血清C反应蛋白（CRP）、基质金属蛋白酶9（MMP-9）和乙酰肝素酶（HPA）水平的相关性。方法选取T2DM患者60例和ACS患者47例为病例组，ACS组中包括不稳定型心绞痛（UAP）27例、急性心肌梗死（AMI）20例；T2DM组中合并ACS（T2DM＋ACS亚组）25例，其中合并UAP（T2DM＋UAP组）15例、合并AMI（T2DM＋AMI组）10例；以同期健康体检者50例为正常对照（NC）组。比较各组血清250HVD、钙离子（Ca抖）、CRP、MMP-9、HPA水平，并分析血清250HVD水平与血清CRP、MMP-9和HPA水平的相关性。结果（1）T2DM组血清Ca2＋和250HVD水平较NC组明显降低（P〈0．05），尤其是DM＋ACS亚组血清Ca^2＋和250HVD水平降低更为明显（P〈0．05），其中T2DM＋AMI组患者血清250HVD水平还低于T2DM＋UAP组患者（P〈0．05）。（2）T2DM组与ACS组血清HPA、MMP-9及CRP水平均明显高于NC组（P〈0．05或P〈0．01）；T2DM＋ACS亚组血清HPA、MMP-9和CRP水平明显高于T2DM组（P〈O．05），且T2DM＋AMI组血清HPA、MMP-9和CRP水平明显高于T2DM＋UAP组（P〈0．05）；AMI亚组血清HPA、MMP-9及CRP水平明显高于UAP亚组（P〈0．01）。（3）T2DM组患者血清250HVD水平与HPA、MMP-9和CRP水平均呈显著负相关，相关系数分别为-0．783、-0．693和-0．741（P均〈0．01）。结论血清250HVD在T2DM及其合并ACS的发生、发展中起一定作用，可作为预测T2DM患者动脉斑块不稳定性的指标，为T2DM的防治提供线索。

The correlation between serum 25-hydroxy vitamin D concentration and CRP,MMP-9, HPA in patients of type 2 diabetes and its acute coronary syndrome

Objective In this experiment,we investigated the change of serum 25OHVD in 2 diabetes with acute coronary syndrome and the correlation with CRP,MMP-9 and HPA. Methods We selected 50 cases of healthy control group,and 47 patients with acute coronary syndrome,in whom 27 were with unstable angina pectoris（UAP） ,and the other 20 were with acute myocardium infarct（AMI）. We selected 60 patients with type 2 diabetes,in whom 35 with type 2 diabetes;and 25 were with acute coronary syndrome,including 15 patients complicated with UAP ,and the other 10 patients were complicated with AMI. It compared the serum 25OHVD level in each group whether the levels have statistical differences, also analyzed the relationship with CRP, MMP-9 and HPA. Results Serum calcium and 25OHVD levels were lower in the type 2 diabetes group compared with the healthy control group,and there were statistical differences in each group（P〈0.05）. Serum calcium and 25OHVD levels were lower in the type 2 diabetes with ACS group compared with the healthy control group,and he serum CRP,MMP-9 andHPA levels were increased significantly,so there were statistical meaning in each group（P〈0. 05）. Using multiple regression analysis, 25OHVD was negatively correlated with CRP,MMP-9,and HPA in the type 2 diabetes. Conclusion Serum 25OHVD was play an important role in the department of ACS,can be seen a material to predict the unstability of plaques in the type 2 diabetes. Provide clues to more active for diabetes prevention and treatment.