糖尿病合并冠状动脉粥样硬化性心脏病患者冠状动脉病变程度与糖化血红蛋白及胆红素水平相关性分析
Analysis of the correlation between the severity of coronary artery lesions and levels of glycated hemoglobin and bilirubin for patients with diabetes and coronary atherosclerotic cardiopathy

目的 探讨糖尿病合并冠状动脉粥样硬化性心脏病（简称冠心病）患者不同冠状动脉病变程度与糖化血红蛋白（HbA1c）及胆红素（TBI）水平的相关性。方法 选取2010年3月—2014年12月至上海长海医院就诊的124例糖尿病合并冠心病患者，根据冠状动脉病变程度分为单支病变组（41例）、双支病变组（42例）、三支病变组（41例），比较不同冠状动脉病变组患者HbA1c、TBI的差异，并分析不同冠状动脉病变程度与HbA1c、TBI的相关性。结果 不同程度的冠状动脉病变组间年龄、体质量指数（BMI）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、糖尿病病程、HbA1c、空腹血糖、TBI之间差异有统计学意义（P<0.05）。多因素logistic回归分析显示，糖尿病病程、HbA1c、TBI等因素为冠状动脉病变程度的独立危险因素（P<0.05）。糖尿病合并冠心病患者冠状动脉病变程度与HbA1c呈正相关（r=0.337, P=0.000），TBI与冠状动脉病变程度呈负相关（r=-0.372, P=0.000）。结论 糖尿病合并冠心病患者冠状动脉病变程度与HbA1c呈正相关，与TBI呈负相关。
： Objective To explore the correlation between the severity of coronary artery lesions and levels of glycated hemoglobin (HbA1c) and bilirubin (TBI) for patients with diabetes and coronary atherosclerotic cardiopathy (coronary heart disease for short). Methods A total of 124 patients with diabetes and coronary heart disease who treated in Shanghai Changhai Hospital from March 2010 to December 2014 were selected. Patients were divided into single-vessel lesion group (41 cases), double-vessel lesion group (42 cases), and three-vessel lesion group (41 cases) according to the severity of coronary artery lesions. The differences of HbA1c and TBI levels among three groups were compared. The correlation between levels of HbA1c and TBI and the severity of coronary artery lesions was analyzed. Results The differences of age, BMI, TC, TG, LDL, HDL, diabetes duration, HbA1c, fasting glucose, and TBI of three groups were statistically significant (P<0.05). The multivariate logistic regression analysis showed that duration of diabetes, HbA1c, and bilirubin were independent risk factors of the severity of coronary artery lesions (P<0.05). The severity of coronary artery lesions of patients with diabetes and coronary heart disease positively correlated to the level of HbA1c (r=0.337, P=0.000) and negatively correlated to the level of TBI (r=-0.372, P=0.000). Conclusion The severity of coronary artery lesions of patients with diabetes and coronary heart disease positively correlates to the level of HbA1c and negatively correlates to the level of TBI