非糖尿病患者糖化血红蛋白、纤维蛋白原及胱抑素C与冠脉狭窄程度的关系
Correlation of glycated hemoglobin, fibrinogen and cystatin C with the severity of coronary artery lesions in non-diabetic patients

摘要：目的 探索非糖尿病患者糖化血红蛋白(HbA1c)、纤维蛋白原(Fbg)以及胱抑素C(Cys C)与冠脉狭窄严重程度的关系。方法 选择接受冠状动脉造影的非糖尿病患者358例，根据造影结果将入选者分为冠心病组和非冠心病组，测定HbA1c、Fbg、Cys C及其他生化指标浓度，计算Gensini积分，并根据Gensini积分将冠心病组分为A、B、C 3个亚组；同时，根据冠心病不同的临床类型将冠心病组分为稳定型心绞痛(SAP)组和急性冠脉综合征(ACS)组。分别比较不同组间HbA1c、Fbg、Cys C水平之间的差异，并对HbA1c、Fbg和Cys C与Gensini积分的关系进行相关性分析。结果 A、B、C亚组的HbA1c、Fbg、Cys C水平均显著高于非冠心病组，且随着Gensini积分的不断增高，这3项指标水平也随之升高(P均<0.05)。ACS组HbA1c、Fbg及Cys C均显著高于SAP组及非冠心病组(P均<0.05)。单因素分析结果表明，HbA1c、Fbg和Cys C均与Gensini积分呈显著正相关(P<0.05)。校正其他影响因素后，HbA1c与Fbg具有相关性(P<0.05)。多因素分析提示，HbA1c、Fbg与Gensini积分相关(P<0.05)。结论 非糖尿病患者HbA1c和Fbg与冠脉狭窄程度密切相关，而Cys C并非冠脉狭窄程度的独立危险因素。
ABSTRACT: Objective To investigate the relationship of glycated hemoglobin (HbA1c), fibrinogen (Fbg) and cystatin C (Cys C) with the severity of coronary artery lesions in non-diabetic patients. Methods We enrolled 358 patients who received coronary angiography (CAG) in this study. They were divided into coronary artery disease (CAD) group and non-CAD group according to CAG results. Moreover, according to different clinical types of CAD, all the CAD patients were further classified into stable angina pectoris (SAP) group and acute coronary syndrome (ACS) group. We calculated Gensini score and divided CAD group into A, B and C subgroups by Gensini score. HbA1c, Fbg, Cys C and other clinical data were measured and compared between groups, and the correlation analysis was used to find the relationship of HbA1c, Fbg and Cys C with Gensini score. Results The levels of HbA1c, Fbg and Cys C were significantly higher in groups A, B and C than in non-CAD group. When Gensini score increased, the three indexes were increased too (P<0.05). The levels of HbA1c, Fbg and Cys C were significantly higher in ACS group than in SAP and non-CAD group (P<0.05). After adjustment for the influencing factors, HbA1c was still associated with Fbg (P<0.05). The levels of HbA1c and Fbg were closely related to Gensini score (P<0.05). Conclusion In non-diabetes patients, HbA1c and Fbg are significantly related to the severity of coronary artery stenosis, and Cys C may not be an independent risk factor of coronary artery stenosis