摘要
目的:探讨冠心病患者胰岛素抵抗与高敏C反应蛋白(hs-CRP)及冠状动脉严重程度间的关系。方法:连续收集冠状动脉造影证实至少有1支血管狭窄≥50%的92例患者作为研究对象,按临床表现分为稳定型心绞痛(SA)41例和急性冠状动脉综合征(ACS)51例,按冠状动脉病变程度分为单支病变组35例、双支病变组28例及3支以上病变组29例。分别测定其空腹血糖、血浆胰岛素、hs-CRP、冠状动脉Genisini评分,用自我平衡模式分析法(HOMA-IRI)作为评价胰岛素抵抗程度的指标。分析胰岛素抵抗、hs-CRP、冠状动脉病变3者间的关系。结果:①SA组与ACS组:hs-CRP(3.34±3.91∶18.39±15.93)、胰岛素抵抗指数(IRI)(1.57±0.96∶3.09±1.64)、Genisini评分(35.31±28.32∶64.74±32.83)差异均有统计学意义(均P<0.01)。②单支病变组与双支、≥3支病变组比较:hs-CRP差异无统计学意义,P>0.05;IRI(2.04±1.17∶2.28±1.64∶3.61±1.53)差异有统计学意义,P<0.05;进一步两两比较后,单支病变组与≥3支病变组的hs-CRP(8.68±11.08∶18.24±18.30)差异有统计学意义,P<0.05。③Gensini评分与IRI、hs-CRP呈正相关(r=0.508,P<0.01;r=0.489,P<0.01),hs-CRP与IRI亦呈正相关(r=0.536,P<0.01)。结论:胰岛素抵抗、hs-CRP与冠状动脉病变程度呈正相关。
Objective：To investigate the the relationship between severity of coronary artery disease（CAD） and high sensitive-C reaction protein（hs-CRP） as well as insulin resistance（IR）. Method：Ninety two CAD patients diagnosed by coronary arteriography were divided into two groups according to clinical sign： 41 patients in stable angina （SA） and 51 patients in acute coronary syndromes （ACS）. And these patients were also divided into three groups according to the number of impaired coronary ateries： 35 patients with one-vessel stenosis, 28 patients with two-vessel stenosis and 29 patients with three-vessel stenosis. All patients were measured fasting blood glucose, fasting insulin, hs-CRP and Genisini scold. The status of insulin resistance was evaluated with HOMA （homeostasis model assessment）. Result ： （1） hs-CRP （3.34±3.91 vs 18.39 ±15.93）, IRI （ 1.57±0.96 vs 3.09±1.64） and Genisini scold （35.31±28.32 vs 64.74±32.83） were significantly lower in SA group than that in ACS group, P〈0.01. （2）IRI （2.04±1.17 vs 2.28±1.64 vs 3.61±1.53） were significantly lower in one-vessel stenosis,two-vessel stenosis group than that in three-vessel stenosis group, P〈0.05; hs CRP（8.68±11.08 vs 18.24±18.30） were significantly lower in one-vessel stenosis group than that in three-vessel stenosis group, P〈0.05.（3）Gensini scold was positive correlated with IR,hs-CRP（r=0. 508 ,P〈0. 01 ;r=0. 489,P〈0.01）, hs-CRP and IR was positive correlated（r= 0. 536, P〈0.01）. Conclusion： IR and hs-CRP were correlated with the degree of coronary artery stenosis.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2008年第10期745-747,共3页
Journal of Clinical Cardiology
关键词
冠状动脉疾病
高敏C反应蛋白
胰岛素抵抗
Coronary diaease
High sensitive-C reaction protein
Insulin resistance
