·糖尿病临床研究·

　　程梭梭 袁莉 吉庆伟

　　作者单位：430022武汉，华中科技大学同济医学院附属协和医院内分泌科

　　通讯作者：袁莉，E-mail: yuanli18cn@yahoo.com.cn

　　【摘要】 目的 探索冠脉病变程度与糖代谢紊乱及β细胞功能的关系，为血糖异常患者预防心血管并发症提供依据。 方法 对183例接受了冠脉造影(CAG)的患者行口服糖耐量试验(OGTT)及胰岛素释放试验(IRT)，分析冠脉病变程度与血糖及β细胞功能的相关性。 结果 在FBG<5.6 mmol/L的糖调节受损(IGR)组中[包括糖耐量减低(IGT)和糖尿病]，2hBG与冠脉病变程度呈正相关(r=0.316，P<0.01)，β细胞功能指数(HOMA-β)与冠脉病变程度呈负相关(r=-0.566，P<0.01);而在FBG>5.6 mmol/L组中，2hBG、HOMA-β与冠脉病变程度不相关(2hBG : r=0.017，P>0.05; HOMA-β:r=-0.280，P>0.05)。 结论 在FBG正常的IGR中，2hBG及β细胞功能损害与冠脉病变程度具有显著相关，而在FBG异常患者中三者的关联减弱。

　　【关键词】冠状动脉造影;口服糖耐量试验;胰岛素释放试验;冠状动脉狭窄

　　doi:10.3969/j.issn.1006-6187.2011.10.012

　　Correlation of the angiography-confirmed coronary stenosis severity with blood glucose and function of pancreatic β cells

　　CHENG Suo-suo, YUAN Li, JI Qing-wei. Department of Endocrinology and Metabolic Disease, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China

　　Corresponding author: YUAN Li, E-mail: yuanli18cn@yahoo.com.cn

　　【Abstract】 Objective To observe the association of the angiography-confirmed coronary stenosis severity with blood glucose and function of pancreatic β cells.   Methods   Oral glucose tolerance test(OGTT) and insulin releasing test(IRT) were done in 183 patients and all study patients underwent coronary angiography(CAG).　Results  The coronary angiography confirmed the coronary heart disease diagnosed by stenosis>50% (CHD, n=118), coronary atherosclerosis diagnosed by stenosis≤50% (CA,n=38) and normal coronary artery (NCA, n=27). The oral glucose tolerance test showed 61 cases with diabetes mellitus (DM), 54 cases with impaired glucose regulation (IGR) and 68 cases of normal glucose tolerance (NGT). Under the condition of FBG<5.6 mmol/L, the 2h plasma glucose of IGT group and DM groups were positively correlated with severity of coronary lesions (P<0.01), and HOMA-β was negatively correlated with severity of coronary lesion (P<0.01). Under the condition of FBG>5.6 mmol/L, 2h-plasma gluose and HOMA-β were not correlated with coronary lesions severity (all P>0.05).   Conclusion   Under the condition of FBG<5.6 mmol/L the 2h-plasma glucose in IGT and DM and HOMA-β are correlated with severity of coronary lesions.

　　【Key words】Coronary angiography; Oral glucose tolerance test; Insulin releasing test; Coronary stenosis