【摘要】 目的 探讨血清高迁移率族蛋白B1(HMGB1)水平的变化对冠心病并发2型糖尿病患者的临床意义。方法 选取2009年3月至11月在我科治疗并经冠状动脉造影诊断的冠心病患者60例,按有无并发糖尿病分为合并糖尿病组(30例)和单纯冠心病组(30例),所有研究对象均测定空腹静脉血HMGB1、高敏C反应蛋白(hs-CRP)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、血脂等指标,采用Gensini积分评价冠状动脉病变严重程度,比较两组间各项指标的差异,并采用多元线性回归分析评价各危险因素与冠状动脉病变严重程度之间的相关性。结果 合并糖尿病组血HMGB1、hs-CRP、FBG、HbA1c均显著高于单纯冠心病组(均P<0.05);合并糖尿病组患者的Gensini积分和三支病变均显著高于单纯冠心病组患者(均P<0.05);线性回归分析显示,冠状动脉病变严重程度与HMGB1、hs-CRP、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、体质量指数(BMI)显著相关。结论 冠心病患者并发2型糖尿病将加重冠状动脉病变严重程度,糖尿病患者血清HMGB1水平升高不仅是糖尿病并发冠心病的重要危险因子,也是反映冠心病合并糖尿病患者冠状动脉广泛弥漫和严重病变的重要指标。更多还原

【Abstract】 Objective To evaluate the clinical value of the serum level of high mobility group box-1 protein(HMGBl) in coronary heart disease(CHD) patients accompanied with type 2 diabetes mellitus(T2DM).Methods A cohort of 60 CHD patients diagnosed by coronary angiography,with age ranging from 43 to 80(66 ± 8)years,who were admitted to our department from March to November 2009 were subjected in this study.They were divided into 2 groups according to whether they were complicated with DM or not,30 cases with DM in group A and 30 cases without DM in group B.Their fasting venous blood samples were collected for the serum levels of HMGBl,high sensitivity C-reactive protein(hs-CRP),fasting blood glucose(FBG),glycosylated hemoglobin Alc(HbAlc),and blood lipids.Gensini score was used to assess the severity of coronary artery lesion.All the parameters were compared and analyzed between 2 groups.Results The serum levels of HMGBl,hs-CRP,FBG and HbAlc were significantly higher in those with DM than those without(all P < 0.05).The patients accompanied with DM also had significantly higher Gensini score and percentage of triple vessel lesion than those without DM(both P < 0.05).Simple correlation analysis indicated that the severity of the coronary artery lesion was significantly correlated with the serum levels of HMGBl,hs-CRP,triglycerides(TG),total cholesterol(TC),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),and body mass index(P< 0.01).Conclusion CHD accompanied with DM aggravates the severity of coronary artery lesions.Elevated serum level of HMGBl is not only an important risk factor for diabetic patients with CHD,but also an important indicator to reflect the diffuse and severe lesions of coronary artery in CHD patients with DM.更多还原