空腹血糖正常的冠心病患者糖代谢状况与血PAI-1，hsCRP，HbA1c及冠脉病变的关系

目的：调查空腹血糖正常的冠心病患者糖代谢状况，探讨冠心病合并糖耐量减低患者血浆纤溶酶原激活物抑制物1（PAI-1）、高敏C反应蛋白（hs—CRP）、糖化血红蛋白（HbA1c）水平与冠脉病变的关系。方法：对冠脉造影确诊的226例冠心病患者行口服葡萄糖耐量试验，据结果分成糖耐量正常（NGT）组，糖耐量减低（IGT）组和2型糖尿病（T2DM）组，分析糖代谢状况，测定三组的血PAI-1，hs—CRP，HbA1c水平和冠脉病变积分。结果：共发现糖代谢异常者120例（53．1％）；血PAI-1，hs—CRP，HbA1c水平和冠脉病变积分在IGT和T2DM组比NGT组明显升高（P〈0．05）；相关分析显示，冠心病合并IGT组血PAI-1，hs—CRP，HbA1c水平和冠状动脉病变积分呈正相关，相关系数分别为，r=0．6082（P〈0．01）、0．4443（P〈0．05）、0．6327（P〈0．01）。结论：空腹血糖正常的冠心病患者糖代谢异常发生率高；冠心病合并IGT者冠脉病变严重，多支冠脉病变发生率高，病变呈弥漫性狭窄；血浆PAI—1，hs—CRP，HbA1c水平和冠状动脉病变严重程度有关。

An analysis of glucose metabolism status and the relationship between the levels of PAI-1,hs-CRP,HbA1c and coronary artery lesions in coronary heart disease patients with normal fasting blood sugar levels

Objective： To investigate the glucose metabolism status in coronary heart disease patients with normal fasting blood sugar levels and research on the relationship between the levels of plasminogen activator inhibitor-1 （PAI-1）, high-sensitive g-reactive protein （hs-CRP）, glycosylated hemoglobin alc （HbA1c） and coronary artery lesions in coronary heart disease patients with abnormal glucose tolerance. Methods： OGTT was performed in 226 cases who were confirmed coronary heart disease with coronary angiography, according to the oral glucose tolerance test （OGTT） results, Patients were divided into 3 groups, which included NGT group with normal fasting blood sugar level, IGT group with impaired glucose tolerance, and TEDM group with type 2 diabetes mellitus. PAI-1, hsCRP, HbA1c were checked and the coronary narrow degree integral was calculated in all of the patients. Results： 120 cases of abnormal glucose metabolism （53.1%） were found. Plasma PAI-1, hs-CRP, HbA1c levels and coronary narrow degree integrals were higher in both IGT group and T2DM group than that in NGT group （P〈0.05）. Correlative analysis showed that plasma PAI-I,hs-CRP,HbAlc levels in coronary heart disease cases with IFG were positively correlated with the coronary narrow degree integrals （Gensini scores）. Correlation coefficient was r=0.6082 （F〈0.01）,0.4443 （P〈0.05） and 0.6327 （P〈0.01）, respectively. Conclusion： The coronary multivessel lesions, severe lesions and diffuse stenosis are more frequent in coronary heart disease patients with IGT. The correlation between the plasma PAI- 1, hs-CRP, HbAlc levels and the severity of coronary artery lesions can reflect the severity of coronary artery lesions.