·糖尿病心血管病·

马立萍 李全民

作者单位：100029北京，北京安贞医院内分泌科

通讯作者：李全民，E-mail:liqm0806@163.com

【摘要】 目的 探讨急性冠脉综合征(ACS)合并糖调节受损(IGR)患者冠脉病变及胰岛素抵抗状况。 方法 回顾分析我院某病区ACS患者174例的冠脉造影及血液学检查资料，根据OGTT 结果 分为两组：合并IGR的96例为ACS+IGR组，不合并IGR的78例为ACS组。另选取冠脉造影正常糖代谢正常者80例为对照组(NC组)。所有患者均进行冠脉造影，计算冠脉病变Gemini积分。应用稳态模型计算胰岛素抵抗指数(HOMA-IR)。 结果 ACS+IGR组与ACS组患者相比心血管事件患病率高，冠脉病变多支、弥漫、病变重。甘油三酯、BMI、高敏C反应蛋白(hsC-RP)、HOMA-IR较ACS组增高。ACS+IGR组和ACS组hsC-RP、胰岛素较NC组高。 结论 合并IGR的ACS患者胰岛素抵抗、炎症反应、合并大血管病变的比率，以及冠脉病变复杂程度均高于糖代谢正常者，提示应早期积极干预IGR，预防大血管病变。

【关键词】 冠心病;冠状动脉造影;糖调节受损

doi:10.3969/j.issn.1006-6187.2011.07.008

Evaluation of characteristics of coronary atherosclerosis and insulin resistance in acute coronary syndrome patients with impaired glucose regulation

MA Li-ping, LI Quan-min. Department of Endocrinology, Beijing Anzhen Hospital of the Capital University of Medical Sciences;Beijing 100029,China

Corresponding author:LI Quan-min, E-mail: liqm0806@163.com

【Abstract】 Objective To evaluate the characteristics of coronary atherosclerosis and insulin resistance in acute coronary syndromes (ACS) patients with impaired glucose regulation. Methods 174 ACS patients were divided into two groups by the results of OGTT test: group of ACS with impaired glucose regulation (IGR) and group of ACS with normal glucose metabolism. Coronary angiography was performed and coronary atherosclerosis gensini score was calculated in all patients. Results Compared with ACS group，Gemini score increased in ACS+IGR group (14.12±3.32 vs 8.92±2.81，P<0.05). Conclusions IGR is closely related with CHD and its stenosis degree.

【Key words】 Coronary heart disease;Coronary angiography; Impaired glucose regulation