糖化血红蛋白及同型半胱氨酸与冠心病的关系

目的探讨糖化血红蛋白(HbA1c)、同型半胱氨酸(hypohomocysteinemia,Hcy)与冠心病(coronary heart dis-ease,CHD)的关系,评价HbA1c联合Hcy检测在CHD中的临床意义。方法收集湛江中心人民医院2009年1月-2010年6月通过冠脉造影确诊为冠心病患者125例为研究对象,根据空腹血糖和HbA1c结果分为单纯冠心病组、冠心病合并糖尿病组之血糖控制良好组及血糖控制不良组;并选择同期健康体检者86例为健康对照组。用免疫透射比浊法测定HbA1c、酶法测定Hcy,比较各组的HbA1c、Hcy、Gensini积分以及三者的相关性。结果比较三组间的HbA1c,冠心病合并糖尿病组与单纯冠心病组及健康对照组比较,差异均具有统计学意义(P<0.05),单纯冠心病组与健康对照组比较差异无统计学意义(P>0.05);而三组间的Hcy两两比较,差异均具有统计学意义(P<0.05);单纯冠心病组、冠心病合并糖尿病组之血糖控制良好组及血糖控制不良组的HbA1c、Hcy、Gensini积分的相关性良好(分别为r=0.79,P<0.05;r=0.89,P<0.05;r=0.97,P<0.05)。结论高HbA1c、Hcy血症与冠心病密切相关,因此对冠心病患者联合检测HbA1c、Hcy,一方面可以快速、准确监测冠心病患者的血糖控制水平,另一方面可以初步评估冠心病病变严重程度,及时制定适当的诊疗措施,从而延缓、降低冠状动脉发生粥样硬化的风险,减少冠心病的发生率及病死率。

Correlation between Coronary Artery Disease and Levels of Glycosylated Hemoglobin and Homocysteine

Objective To investigate the relationship between the levels of glycosylated hemoglobin(HbA1c),homocysteine(Hcy) and coronary heart disease(CHD),and evaluate the clinical significance of testing HbA1c and Hcy in CHD patients.Methods The clinical data of 120 patients with CHD confirmed by coronary angiography were collected from Zhanjiang People’s Hospital from January 2009 to June 2010.According to the results of fasting plasma glucose and HbA1c,the patients were divided into three groups:CHD group,CHD with diabetes group which included good blood glucose control group and poor blood glucose control group;86 healthy elderly were chosen as control group.The immune turbidimetric method was used to determinate HbA1c and ELISA method to determinate Hcy.The level of HbA1c,Hcy,Gensini score and the correlation among those groups were compared.Results The level of HbAlc in the CHD with diabetes group was significantly different from the CHD group and control group(P<0.05).There was no difference significance between CHD group and control group(P>0.05);the differences in Hcy were statistically significant among the three groups(P<0.05);There was good correlation among HbA1c,Hcy and Gensini score in,CHD and diabetes group(both good blood glucose control group and poor blood glucose control group) and CHD group(r=0.79,P<0.05;r=0.89,P<0.05;r=0.97,P<0.05,respectively,).Conclusion HbA1c,Hcy is closely related to hyperlipidemia and CHD,so the combined detection of HbA1c and Hcy can quickly and accurately monitor the level of blood glucose control,and also can be used to assess the serious degree of CHD development,and provide the appropriate treatment measures timely,decrease the risk of coronary artery atherosclerosis and reduce the incidence of CHD and mortality.