PCT及Hcy与NIDDM合并CHD患者冠状动脉病变的相关性

目的 了解降钙素原（procalcitonin，PCT）和同型半胱氨酸（homocysteine，Hcy）在糖尿病（non-insulin-dependent diabetes mellitus，NIDDM）和（或）冠心病（coronary heart disease，CHD）患者体内含量的差异，探讨改两种生化指标含量表达对2型糖尿病合并冠心病患者冠状动脉病变程度的具体影响。方法 2012年8月~2017年1月期间，对笔者医院收治的50例健康体检中心的健康居民、50例2型糖尿病患者、50例冠心病患者、50例2型糖尿病复合冠心病患者进行研究，分析不同组别对象和不同影响因素（长期吸烟史、长期饮酒史、家族史、病情、病变支数）钙素原和同型半胱氨酸表达含量、Gensini评分（冠脉病变评分）的具体差异，分析不同组别对象钙素原、同型半胱氨酸、Gensini评分的相互差异；综合分析各影响因素、钙素原和同型半胱氨酸表达含量对糖尿病合并冠心病患者Gensini评分的综合影响。结果 4组对象降钙素原和同型半胱氨酸含量、Gensini评分的差异均有统计学意义，具体两两比较发现，健康组和DM组、健康组和CHD组、健康组和DM复合CHD组、DM组和DM复合CHD组之间均有3项指标（降钙素原、同型半胱氨酸、Gensini评分）的差异有统计学意义（P均<0.05），DM组和CHD组降钙素原指标比较差异有统计学意义；4个组别对象均进行降钙素原、同型半胱氨酸含量、Gensini评分分别进行两两之间的相关性分析，结果均显示相关性差异均有统计学意义（P均<0.05）；糖尿病合并冠心病患者的长期吸烟史、长期饮酒史对同型半胱氨酸和Gensini评分影响明显（P均<0.05），病情、家族史、病变支数均对Gensini评分影响明显（P均<0.05），不同基本情况对象降钙素原含量的差异无统计学意义（P均>0.05）；各因素对Gensini评分影响程度依次为病变支数（OR=7.24）、PCT含量（OR=5.87）、Hcy含量（OR=5.75）、病情（OR=5.21）、长期饮酒史（OR=3.63）、长期吸烟史（OR=2.86）、家族史（OR=2.56）。结论 糖尿病和（或）冠心病发病情况对降钙素原、同型半胱氨酸含量表达均有明显影响，对2型糖尿病合并冠心病患者冠状动脉病变程度影响尤为显著，通过多项指标或资料联合采集、检测，有助于2型糖尿病合并冠心病患者临床病情的具体评估。

Correlation among Procalcitonin and Homocysteine and Type 2 Diabetes Mellitus with Coronary Artery Disease

Objective To investigat the level differences between procalcitonin and homocysteine in patients with diabetes and/or coronary heart disease (CHD), and explored the specific impact of the two biochemical indexes on degrees of coronary artery lesions of patients with type 2 diabetes mellitus (DM) and coronary heart disease. Methods During August 2012-January 2012, 50 healthy residents, 50 patients with type 2 DM, 50 patients with CHD, and 50 patients with type 2 DM and CHD (DM+CHD), from our hospital physical examination center were studied. Comprehensive difference analysis of procalcitonin and homocysteine levels, and Gensini scores, among each groups and different influencing factors (long-term disease history, family history, smoking history, long-term drinking, the lesion count), were performed to understand how the influencing factors, the procalcitonin and homocysteine expression levels affect the Gensini scores of patients with diabetes mellitus combined with coronary heart disease. Results The differences of procalcitonin and homocysteine levels, and Gensini scores, among the four groups, were statistically significant. The comparison study found that three indicators (calcitonin original,homocysteine,Gensini score) between healthy group and DM group, healthy group and CHD group, healthy group and DM+CHD group, DM group and DM+CHD group were significantly different (P<0.05). Procalcitonin levels between DM group and CHD group was statistically significant. Paired correlation analysis showed a statistical significance of procalcitonin, homocysteine and Gensini score in all four groups (P<0.05); Long-term smoking and drinking history in patients with DM+CHD displayed a significant effect on homocysteine and Gensini scores (P<0.05). Furthermore, the illness condition, family history, and the number of lesions showed a significant influence on the Gensini score (P<0.05). There was no significant difference in procalcitonin among different basic conditions (P>0.05). The influence degree of each factor on the Gensini score were:lesion number (OR=7.24), PCT content (OR=5.87), Hcy content (OR=5.75), illness condition (OR=5.21), long-term drinking history (OR=3.63), smoking history (OR=2.86) and family history (OR=2.56). Conclusion The incidence of DM and/or CHD has significant effects on the expression of procalcitonin and homocysteine, and it is particularly significant in the influence of coronary artery in patients with type 2 DM and CHD. In summary, the results of our study indicated that collecting and testing of multiple indicators and data can be a helpful assessment of the clinical condition of patients with type 2 DM and CHD.