2型糖尿病患者血清总胆红素、尿酸与冠脉病变的关系

目的:探讨2型糖尿病患者血清总胆红素、尿酸与冠脉病变程度之间的关系。方法:65例2型糖尿病及157例非糖尿病患者行冠状动脉造影检查,冠脉狭窄>50%者确诊为冠心病组,冠脉造影未见狭窄者为冠脉正常组。再按照病变血管严重程度分为单支、双支、三支3组。糖尿病患者按照上述条件分组,并检测血清总胆红素及尿酸、血糖、血脂等生化指标。结果:糖尿病患者冠脉造影阳性率为78.46%,冠脉复杂病变的比例为72.55%,均明显高于非糖尿病患者,差异有统计学意义(均P<0.01)。糖尿病合并冠心病患者血清总胆红素降低,尿酸升高,与单纯糖尿病组比较差异有统计学意义(P<0.01或P<0.05)。糖尿病合并冠心病患者,双支、三支病变组与单支病变组比较,血清总胆红素降低,尿酸升高,差异有统计学意义(P<0.01或P<0.05)。结论:糖尿病患者冠心病发病及冠脉病变严重程度明显高于非糖尿病患者。糖尿病合并冠心病患者血清胆红素降低、尿酸升高,且胆红素降低、尿酸升高程度与冠脉病变复杂程度一致。

Relationship among Total Serum Bilirubin,Uric Acid and Coronary Lesion in Patients with Type 2 Diabetes Mellitus

Objective: To study the relationship among total serum bilirubin,uric acid and coronary lesion in patients with type 2 diabetes mellitus(T2DM). Methods: Two hundred and twenty-two patients undergoing diagnostic coronary angiography were divided into coronary heart disease(CHD) group (>50% diameter narrowing) and control group. Sixty-five patients with T2DM were further divided into four subgroups,the single-branch group,the double-branch group,the three-branch group and non-CHD group. Total bilirubin,uric acid,blood glucose,total cholesterol(TC),triglycerides (TG),high-density lipoprotein(HDL),low-density lipoprotein(LDL) were measured in all of the four groups of patients with T2DM. Results: In patients with T2DM,the positive rate of diagnostic coronary angiography was 78.46% and the ratio of complicated coronary lesion was 72.55%. Both of them were higher than those of the non-diabetes mellitus patients(P < 0.01). The levels of total serum bilirubin were lower in T2DM and CHD group than those of the diabetes mellitus and non-CHD group(P < 0.01). The levels of total serum bilirubin were lower in the double-branch group and the three-branch group than those of the single-branch group (P < 0.01). The levels of serum uric acid were higher in T2DM and CHD group than those of the diabetes mellitus and non-CHD group(P < 0.01). And the higher levels of serum uric acid were corresponded with the more severity of coronary lesion in T2DM and CHD patients. Conclusion: There is higher morbidity and more complicated coronary lesion in T2DM patients than those of the non-diabetes mellitus. Low level of serum bilirubin and high level of uric acid may be correlated with the severity of coronary lesion in CHD patients with T2DM by indirectly assessing the coronary lesion.