冠心病并糖耐量受损患者胰岛素抵抗与冠状动脉病变程度的相关性研究

发布时间：2018-06-28 06:12

本文选题：冠心病 + 糖耐量受损　；参考：《中国动脉硬化杂志》2017年01期

【摘要】：目的探讨冠心病合并葡萄糖耐量受损(IGT)患者胰岛素抵抗(IR)与冠状动脉病变程度之间的关系。方法 152例冠心病并IGT患者及35例冠心病非IGT患者(对照组),采用HOMA2法测定IR指数(HOMA2-IR),采用Gensini积分系统定量评定冠状动脉狭窄程度,B2/C型病变定义为冠状动脉形态学复杂病变。以HOMA2-IR四分位数为切点将冠心病并IGT患者分为4组:第1四分位数组(n=38)、第2四分位数组(n=38)、第3四分位数组(n=38)、第4四分位数组(n=38),比较5组基线资料及冠状动脉造影结果。结果 5组间餐后2 h血糖(2h PBG)、糖化血红蛋白(Hb A1c)、空腹胰岛素和Gensini积分逐渐增高,差异有统计学意义(P0.01)。第4四分位数组多支病变和B2/C病变明显高于第1四分位数组和对照组(P0.05)。相关性分析显示,Gensini积分与HOMA2-IR(r=0.712,P0.001)存在较强的正相关。多元逐步回归分析显示,HOMA2-IR、Hb A1c和2h PBG是影响冠状动脉狭窄程度的独立危险因素。Logistic回归分析显示,HOMA2-IR是多支病变和B2/C病变的独立危险因素。结论IR是反映冠心病并IGT患者冠状动脉狭窄程度的重要指标。
[Abstract]:Objective to investigate the relationship between insulin resistance (IR) and severity of coronary artery disease in patients with coronary heart disease complicated with impaired glucose tolerance (IGT). Methods the IR index (HOMA2-IR) was measured by HOMA2 method in 152 patients with coronary heart disease complicated with IGT and 35 patients with non-IGT coronary heart disease (control group). The degree of coronary artery stenosis was quantitatively evaluated by Gensini integral system. The patients with coronary heart disease and IGT were divided into 4 groups with HOMA2-IR quartile as the cutting point: the first quartile array (nf38), the 2nd quartile array (nnm38), the 3rd quartile array (nf38), and the 4th quartile array (nf38). The results of baseline data and coronary angiography were compared among the 5 groups. Results 2 h postprandial blood glucose (2h PBG), HbA1c, fasting insulin and Gensini score increased gradually in the five groups (P0.01). The multivessel lesions and B _ 2 / C lesions in the 4th quartile array were significantly higher than those in the 1st quartile array and the control group (P0.05). Correlation analysis showed that there was a strong positive correlation between Gensini integral and HOMA2-IR (r = 0.712, P 0.001). Multiple stepwise regression analysis showed that HOMA2-IRB HbA1c and 2h PBG were independent risk factors for coronary artery stenosis. Logistic regression analysis showed that HOMA2-IR was an independent risk factor for multivessel and B _ 2 / C lesions. Conclusion IR is an important index to reflect the degree of coronary artery stenosis in patients with coronary heart disease and IGT.
【作者单位】：郑州大学附属洛阳中心医院心血管内科;同济大学附属上海第十人民医院心血管内科;郑州大学第一附属医院心血管内科;
【基金】：洛阳市科技攻关项目(1201050A-1)
【分类号】：R541.4;R587.1

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