摘要
目的分析血糖变异性与冠状动脉粥样硬化在不同人群中的差异,探讨两者间的影响及其可能机制。方法 118例行选择性冠状动脉造影患者,根据是否合并冠心病和2型糖尿病分为A组(32例,无冠心病、无2型糖尿病)、B组(8例,无冠心病、有2型糖尿病)、C组(36例,有冠心病、无2型糖尿病)和D组(42例,有冠心病和2型糖尿病)。所有研究对象完成常规数据检测,根据冠状动脉造影结果计算冠状动脉病变Gensini积分。B组和D组接受72 h动态血糖监测,计算平均血糖波动幅度(MAGE)、血糖平均绝对差(MODD)、平均餐后血糖波动幅度(MPPGE)等指标,比较四组各项指标的差异,进一步分析Gensini积分与影响因素的相关性及其独立危险因子。结果与A组比较, B组和D组的年龄、收缩压、糖化血红蛋白(HbA1c)、超敏C反应蛋白(hs-CRP)更高,差异有统计学意义(P<0.05)。与B组比较, D组的MAGE、MPPGE、hs-CRP、Gensini积分更高,体质量指数(BMI)更低,差异有统计学意义(P<0.05),但年龄、HbA1c、收缩压、舒张压、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)和甘油三酯(TG)水平、性别、吸烟史比较,差异无统计学意义(P>0.05)。Gensini积分与HbA1c、MAGE、MPPGE、hs-CRP水平呈正相关(r=0.651、0.675、0.718、0.714, P<0.05),与年龄、收缩压无关。MAGE、MPPGE是影响Gensini积分的独立危险因子。结论血糖变异性大可能导致更严重的冠状动脉粥样硬化,内皮功能损害可能参与了其中的过程。
Objective To analyze the differences between blood glucose variability and coronary atherosclerosis in different populations, and to explore the effects and possible mechanisms between them. Methods A total of 118 patients with selective coronary angiography were divided by whether complicated with coronary heart disease and type 2 diabetes mellitus in group A(32 cases, without coronary heart disease and type 2 diabetes mellitus), group B(8 cases, without coronary heart disease but type 2 diabetes mellitus), group C(36 cases, without type 2 diabetes mellitus but coronary heart disease), and group D(42 cases, with coronary heart disease and type 2 diabetes mellitus). All subjects completed routine data testing and calculated Gensini scores for coronary lesions based on coronary angiography results. Group B and group D were monitored for 72 hours. The mean amplitude of glycemic excursions(MAGE), mean of daily differences(MODD), mean postprandial glucose excursion(MPPGE) and other indicators were calculated. The differences among the four groups were compared, and the correlation between Gensini integral and influencing factors and its independent risk factors were further analyzed. Results Compared with group A, group B and group D had higher age, systolic blood pressure, glycosylated hemoglobin(HbA1c) and hypersensitive C-reactive protein(hs-CRP), and the difference was statistically significant(P<0.05). Compared with group B, group D had higher MAGE, MPPGE, hsCRP and Gensini integral, and lower body mass index(BMI). Their difference was statistically significant(P<0.05), but there was no statistically significant difference in age, HbA1c, systolic blood pressure, diastolic blood pressure, total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C) and triglyceride(TG) levels, sex, smoking history(P >0.05). Gensini score was positively correlated with HbA1c, MAGE, MPPGE and hs-CRP levels(r=0.651, 0.675, 0.718, 0.714, P<0.05), but not with age and systolic blood pr
作者
蒲云飞
王沛坚
冉擘力
李民凤
李叶青
PU Yun-fei;WANG Pei-jian;RAN Bo-li(First Affiliated Hospital of Chengdu Medical College,Chongqing 400014,China)
出处
《中国实用医药》
2019年第2期1-4,共4页
China Practical Medicine
基金
2016重庆市卫生计生委医学科研项目基金资助(项目编号:2016MSXM073)
关键词
血糖变异性
2型糖尿病
冠状动脉粥样硬化
内皮功能损害
Blood glucose variability
Type 2 diabetes mellitus
Coronary atherosclerosis
Endothelial dysfunction
