【摘要】 目的探讨2型糖尿病(T2DM)合并冠心病(CAD)患者糖化血红蛋白(HbA1c)水平与冠脉病变特点的关系。方法 289例T2DM合并CAD患者,按照HbA1c水平分为两组,A组103例(HbA1c<7%),B组186例(HbA1c≥7%),对两组患者冠脉造影结果进行Gensini积分并对比分析。结果 B组患糖尿病史、吸烟比例和微量白蛋白尿阳性率均高于A组,空腹血糖、总胆固醇、甘油三酯、血尿酸水平也高于A组;从冠脉病变看,三支病变、弥漫性病变、冠脉C型病变,B组显著高于A组,且B组冠脉病变Gensini积分较高(P<0.01),HbAlc水平与Gensini积分呈正相关(P<0.01)。结论 T2DM合并CAD患者HbAlc水平高,其冠脉病变呈现复杂和严重的临床特点。因此,T2DM合并CAD患者应尽早积极有效地控制血糖水平,对于冠心病的防治甚为重要。更多还原

【Abstract】 Objective To investigate the relationship between HbA1c and the angiographic characteristics of coronary artery disease(CAD)in patients with type 2 diabetes.Methods A total of 289 patients with type 2 diabetes combined CAD were divided into two groups according to the level of HbA1c.One hundred and three patients were in group A with HbA1c<7% and 186 patients in group B with HbA1c≥7%.The angiographic characteristics of coronary artery among them were analyzed and the Gensini score were compared between the two groups.Results The ratio of type 2 diabetes,positive microalbuminuria(Malb)and smoking were higher in group B,and the level of glucose,cholesterol,triglyceride and uric acid were higher in group B(all P<0.05).The patients in group B had more three branches disease and type C coronary artery disease(P<0.05).The angiographic characteristics were more extensive and the Gensini scores in group B were higher than those in group A(49.42±34.60 vs 39.14±27.83,P<0.01),and the level of HbA1c was positively correlated to Gensini score in all the patients(P<0.01).Conclusions HbA1c is an independent risk factor in patients with type 2 diabetes combined coronary artery disease,and well control of glucose is critical for the treatment of CAD.更多还原