摘要
目的研究糖尿病患者糖化血红蛋白(Hb A1c)水平变化对高血压以及冠心病的临床影响。方法选择2014年4月至2017年4月诊治的182例内分泌疾病患者进行回顾性研究,根据是否患有糖尿病将其分为两组,对照组的88例为非糖尿病患者,观察组的94例为糖尿病患者,比较两组患者的血脂、血糖水平;依据患者有无高血压及冠心病将糖尿病患者分为对应的组,比较每个组之间的Hb A1c水平。分析糖尿病患者糖化血红蛋白(Hb A1c)水平的相关的因素。结果通过对血脂比较,两组患者的TC、TG、LDL-C水平差异无统计学意义(P>0.05);但观察组患者的HDLC水平明显比对照组低,两组差异有统计学意义(P<0.05)。观察组患者的SBP和DBP水平及血糖FPG和FINS指标及hs-CRP及Hb A1c水平均明显比对照组高,差异有统计学意义(P<0.05)。合并高血压组患者的Hb A1c水平明显比非高血压组高,差异有统计学意义(P<0.05)。合并冠心病组患者的Hb A1c水平明显比非冠心病组高,差异有统计学意义(P<0.05)。Pearson相关分析结果指出,糖尿病组患者的Hb A1c水平与SBP、DBP及hs-CRP水平呈正相关(P<0.05)。通过对糖尿病组患者血血糖水平与糖化血红蛋白水平相关性进行分析,得出两者具有正相关性。通过多因素分析结果发现,患者Hb A1c水平相关的因素有年龄、性别、体重指数、收缩压、舒张压、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、谷胺酰转肽酶等等。结论糖尿病患者Hb A1c水平与血压以及hs-CRP水平呈正相关,能够有效的预测高血压以及冠心病的出现,临床要加强对Hb A1c水平的监测,对于Hb A1c水平较高的糖尿病患者来说应注意预防及筛查高血压及冠心病。
Objective To explore the clinical significance of changes in blood levels of glycosylated hemoglobin(Hb Alc) on hypertension and coronary heart disease in patients with diabetes millitus,and to provide theoretical basis for future clinical study.Methods The clinical data of 182 patients with endocrinosis treated in this hospital during April 2014 to April 2017 were retrospectvely reviewed and studied,they were divided into 2 groups according to whether patients with diabetes or not,88 patients without diabetes were listed in control group,and 94 patients with diabetes were enrolled in observation group,and the blood levels of lipids and glucose were compared between these 2 groups,and these patients were further divided into corresponding subgroups according to whether they were associated with hypertension and coronary heart disease(CHD)and levels of Hb Alc in patients of each group were compared.The related factors of glycosylated hemoglobin(Hb A1 c) levels in patients with diabetes mellitus were further analyzed.Results Through the comparison of blood lipids,the difference in blood levels of TC,TG and LDL-C between these 2 groups was not statistically significant(P > 0.05).But the level of HDL-C in observation group was significantly lower than that of control group,and the difference between these two groups was statistically significant(P < 0.05).Patients in observation group with levels of SBP and DBP and blood levels of glucose FPG and FINS index and levels of hs-CRP and Hb A1 c were significantly higher in observation group than those of control group,and the difference was statistically significant(P < 0.05).The level of Hb A1 c was obviously higher in hypertension group than that of non-hypertension group,and the difference was statistically significant(P < 0.05).The level of Hb A1 c in patients with coronary heart disease complicated with hypertension was significantly higher than that of patients with coronary disease without hypertension group,and the difference was statistically significant(P < 0.05).The result of Pearson correlation analysis showed that the levels of Hb A1 c and hs-CRP and SBP,DBP were positively correlated in diabetic groups(P < 0.05).The relationship between blood levels of glucose and glycated hemoglobin in blood analysis of diabetic patients.The results showed that these two indicators have positive correlation.The results of multiple factor analysis indicated that the related factors of Hb A1 c level were age,gender,body mass index,systolic blood pressure,diastolic blood pressure,levels of fasting blood glucose,total cholesterol,triglyceride,high density lipoprotein cholesterol,low density fat cholesterol,alanine aminotransferase,aspartate aminotransferase,glutamic acid transaminase,and so on.Conclusion Hb A1 c level,blood pressure and level of hs CRP are positively correlated in diabetic patients,they can be applied as effective predictors of hypertension and coronary heart disease(CHD).It is important in clinical practice to strengthen monitoring on level of Hb A1 c.If level of Hb A1 c is elevated in diabetic patients,it should pay more attention to screen and prevent the complications of hypertension and coronary heart disease(CHD) in diabetic patents.
出处
《临床和实验医学杂志》
2018年第2期166-169,共4页
Journal of Clinical and Experimental Medicine
关键词
糖尿病
糖化血红蛋白
高血压
心血管疾病
相关性研究
Diabetes millutus
Glycosylated hemoglobin
Hypertension
Cardiovascular disease
Correlation
