【摘要】 目的:探讨2型糖尿病(T2DM)患者并发冠心病的危险因素及其与冠状动脉病变程度的相关性。方法:选取2015年1月至2017年6月在黑龙江省佳木斯中心医院行冠状动脉造影的T2DM患者200例,根据冠状动脉造影结果分为冠状动脉轻度狭窄组(轻度组,冠脉狭窄<75%,70例)、冠状动脉重度狭窄组(重度组,冠脉狭窄≥75%,66例)和无明显狭窄病变的对照组(64例)。检测患者血压、血脂、血糖、糖化血红蛋白(HbA1c)及血清25羟基维生素D[25(OH)D]水平。结果:轻度组和重度组收缩压(SBP)、舒张压(DBP)及低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、尿酸、空腹血糖(FBG)和HbA1c水平均显著高于对照组,而血清25(OH)D和高密度脂蛋白胆固醇(HDL-C)水平均显著低于对照组;重度组SBP、DBP、LDL-C、TC、尿酸、FBG和HbA1c水平均显著高于轻度组,而血清25(OH)D水平显著低于轻度组,差异均有统计学意义(均P<0.05)。Pearson相关分析显示,冠脉狭窄程度与年龄、SBP、LDL-C、TC、TG、尿酸、FBG和HbA1c呈正相关关系(P<0.05),与血清25(OH)D水平和HDL-C呈负相关关系(P<0.05)。多元Logistic回归分析提示LDL-C、TC、FBG和HbA1c是冠脉狭窄程度的危险因素,血清25(OH)D水平是冠脉狭窄程度的保护因素(P<0.05)。三支冠脉病变患者血清25(OH)D水平明显低于双支冠脉病变和单支冠脉病变(P<0.05)。结论:冠心病合并T2DM患者血清25(OH)D水平与冠状动脉病变支数及其严重程度密切相关。更多还原

【Abstract】 Objective:To explore the risk factors for coronary heart disease in patients with type 2 diabetes mellitus(T2DM)and the relationship between serum 25-hydroxyvitamin D and the extent of coronary artery disease.Methods:A total of 200 patients with T2DM treated in our hospital from January 2015 to June2017 were selected,and divided into three groups according to the results of coronary angiography:mild stenosis group(n=70),severe stenosis group(n=66)and control group(no obvious stenosis,n=64).The blood pressure,blood lipids,blood glucose,glycosylated hemoglobin(HbA1c)and serum 25-hydroxyvitamin D [25(OH)D]levels were detected.Results:The mild stenosis group and the severe stenosis group patients had higher systolic blood pressure(SBP),diastolic blood pressure(DBP),low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),uric acid,fasting blood glucose(FBG)and HbA1c levels than the controls,while the serum 25(OH)D and high-density lipoprotein cholesterol(HDL-C)levels were significantly lower(P<0.05).The SBP,DBP and the levels of LDL-C,TC,uric acid,FBG and HbA1c in the severe group were significantly higher than those in the mild group,while the serum 25(OH)D level was significantly lower(P<0.05).Pearson correlation analysis showed that coronary stenosis degree was positively correlated with the age,SBP,LDL-C,TC,TG,uric acid,FBG and HbA1c,and it was negatively correlated with serum 25(OH)D and HDL-C levels.Multivariate logistic regression analysis showed that LDL-C,TC,FBG and HbA1c were risk factors for the severity of coronary artery stenosis.Serum 25(OH)D level was a protective factor for the degree of coronary stenosis.Triple vessel disease patients had significantly lower serum 25(OH)D level than double vessel and single disease vessel patients.Conclusion:Serum25(OH)D level was correlated with the extent of coronary artery disease in T2DM patients with coronary heart disease.更多还原