【摘要】 目的 通过检测不同糖耐量组冠心病(CHD)患者可溶性血管细胞黏附分子(SVCAM-1)、可溶性细胞间黏附分子(SICAM-1)和高敏C-反应蛋白(hs-CRP)水平，探讨不同糖代谢水平的CHD患者是否存在不同血管内皮功能和炎症状态，以及阿卡波糖对其的影响。方法根据OGTT结果将96例CHD患者分成糖代谢正常(NGT)组、IGT组和T2DM组，检测上述各组和对照(NC)组血清SVCAM-1、SICAM-1及hs-CRP浓度，对比与糖代谢各参数的相关性。观察阿卡波糖对IGT组和T2DM组SVCAM-1、SICAM-1、hs-CRP的影响。结果 IGT组和T2DM组血清SVCAM-1、SICAM-1、hs-CRP浓度高于其他组，血清SVCAM-1、SICAM-1与HbA1c(r=0.51、0.39，P<0.01)及hs-CRP呈正相关(r=0.56、0.32, P<0.01)。T2DM组SICAM-1与HbA1c、hs-CRP有更好的相关性(r=0.65、0.71, P<0.001)。阿卡波糖治疗组比常规治疗组SVCAM-1、SICAM-1和hs-CRP浓度降低明显。结论 在CHD患者中，血清SVCAM-1、SICAM-1和hs-CRP浓度根据糖耐量水平的分组逐步升高，提示内皮受损、炎症状态可能是CHD合并糖代谢异常患者的重要的病理生理因素。阿卡波糖可能通过改善内皮功能和炎症状态，在CHD合并糖代谢异常患者治疗中起重要作用。

　　【关键词】 可溶性血管细胞黏附分子;可溶性细胞间黏附分子;冠心病;糖耐量;糖尿病，2型

Observation of soluble adhesion molecules levels of coronary heart disease patients with different glucose tolerance and their influence of acarbose WU Bo, MA Jin, CHEN De，et al. Department of Cardiology, Affiliated Yangpu Hospital of Tongji University, Shanghai, 200090, China

Corresponding author: MA Jin, E-mail：majin6812@163.com

　　【Abstract】Objective To investigate the endothelial dysfunction and inflammatory status in coronary heart disease(CHD) patients with different glucose tolerance and the influence of acarbose by detecting the levels of soluble vascular cell adhesion molecules (SVCAM-1), soluble intercellular adhesion molecules (SICAM-1) and high sensitivity C-reactive protein(hs-CRP). Methods The 96 CHD patients were divided into NGT, IGT and T2DM group according to OGTT. The levels of serum SVCAM-1, SICAM-1 and hs-CRP were measured.The correlation among indicators of glucose metabolism and the influence of acarbose on serum SVCAM-1, SICAM-1 and hs-CRP was analyzed. Results The levels of serum SVCAM-1 and , SICAM-1 and hs-CRP were higher in IGT and T2DM groups were higher than in NGT and control NC group,. The level of SVCAM-1 and SICAM-1 were positively correlated with and HbA1c(r=0.51, vs 0.39, respectively, P<0.01) and hs-CRP(r=0.56 vs ,0.32, respectively, P<0.01), ) The SICAM-1 level was positively correlated with HbA1c and hs-CRP in T2DM group(r=0.65 vs 0.71, P<0.01).The levels of serum SVCAM-1, SICAM-1 and hs-CRP were significantly lower in acarbose treatment group than routine treatment group.Conclusion SVCAM-1 , SICAM-1 and hs-CRP levels are gradually increased along with glucose tolerance worsening in CHD patients. It is showed that endothelium impairment and inflammatory state may be the important pathophysiological factors in CHD patients for abnormal glucose metabolism by the increased levels of SVCAM-1, SICAM-1 and hs-CRP.Acarbose improves glucose tolerance abnormality through improving inflammatory state and endothelial dysfunction.

　　【Key words】 Soluble vascular cell adhesion molecules;Soluble intercellular adhesion molecules;Coronary heart disease;Glucose tolerance;Diabetes mellitus，type 2