·HbA1c的应用·

    　莫显刚、曹广煜、杨  彦、张亚梅、肖   雷、王   鹏、陈庆伟、李兴升、吴志勤、李桂琼、柯大智、邓    玮、王   丽

　　作者单位：400010重庆医科大学附属第二医院老年心血管病科

　　【摘要】目的探讨HbA1c水平与冠状动脉病变程度的相关性及临床意义。方法对临床疑诊或诊断为冠心病(CHD)而行冠状动脉造影的541例患者进行HbA1c测定分组,评价HbA1c水平与CHD、冠脉狭窄程度 (Gensini积分法)、冠脉狭窄支数及接受PCI治疗等的相关性。结果随HbA1c水平升高，CHD患病率显著上升(P<0.01),Spearman等级相关分析显示，HbA1c与CHD、病变支数、Gensini积分和接受PCI治疗显著相关(r=0.211,P<0.01;r=0.213,P<0.01;r=0.233,P<0.01;r=0.137，P<0.01)。Logistic多元逐步回归分析结果显示，HbA1c为CHD的独立危险因素(OR=1.436，95%CI为 1.128～1.828，P<0.01)。结论HbA1c与冠脉病变程度呈正相关,长期升高可能促进CHD的发生。

　　【关键词】糖化血红蛋白;冠心病;冠脉狭窄程度积分;经皮冠状动脉介入

　　doi:10.3969/j.issn.1006-6187.2011.12.009

　　Correlation between HbA1c level and severity of coronary artery diseaseWANG Peng，CHEN Qing-wei，LI Xing-sheng，et al. Department of Geriatric Hedicine, Second Hospital, Chongqing Medical Univeristy, Chongqing 400010,China

　　【Abstract】   Objective   To study the relationship between glycosylated hemoglobin　(HbA1c)level and severity of coronary artery disease.    Methods   541 cases with suspected or confirmed coronary heart disease undergoing coronary angiography were grouped according to the level of HbA1c.The relationship of HbA1c level with coronary heart disease, coronary stenosis (Gensini score method), number of diseased coronary branches and acceptance of PCI treatment was evaluated. Results   Along with the increased HbA1c level, the prevalence of coronary heart disease was significantly higher(P<0.01). Spearman rank correlation test showed that HbA1c level had a positive correlation with coronary heart disease, number of diseased coronary branches, Gensini’s score or PCI (r=0.211,P<0.01;r=0.213,P<0.01;r=0.233,P<0.01;r=0.137，P<0.01).Multiple logistic regression analysis showed that HbA1c was an independent risk factor for CHD(OR=1.436，95%CI 1.128～1.828，P<0.01).Conclusion   HbA1c level is positively correlated with the coronary artery disease and has a predictive value of CHD.

　　【Key words】Hemoglobin A1c;Coronary heart disease;Coronary stenosis score