摘要
目的探讨2型糖尿病并发冠心病患者血生长停滞特异性基因产物6(Gas6)水平变化及意义。方法收集2型糖尿病患者89例(T2DM组)、冠心病患者85例(冠心病组)和T2DM合并冠心病患者88例(T2DM并冠心病组)。同时选取同期性别、年龄与病例组匹配的健康体检者作为对照组,共80例。比较各组收缩压(SBP)、舒张压(DBP)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、三酰甘油(TG)、低密度或高密度脂蛋白胆固醇(LDL-C或HDL-C)、超敏C反应蛋白(Hs-CRP)及Gas6水平差异,分析Gas6与其他临床指标的关系,对T2DM并发冠心病进行多因素回归分析。结果冠心病组收缩压、舒张压、FBG、HbAlc、TG、LDL-C、hs-CPR、Gas6水平分别为(134.3±17.0)mmHg(1 mmHg=0.133 kPa)、(84.3±11.2)mmHg、(5.4±0.3)mmol/L、(4.9±0.7)%、(2.4±0.6)mmol/L、(2.8±0.6)mmol/L、(3.1±0.8)mg/l、(280.2±6.9)pg/L,T2DM组分别为(135.1±16.7)mmHg、(80.1±8.9)mmHg、(8.0±0.9)mmol/L、(7.8±0.9)%、(2.3±0.5)mmol/L、(2.8±0.5)mmol/L、(2.9±0.7)mg/L、(275.1±6.7)pg/L,T2DM并冠心病组分别为(140.7±19.6)mmHg、(84.8±11.5)mmHg、(9.3±1.1)mmol/L、(9.1±1.4)%、(3.0±0.6)mmol/L、(3.0±0.6)mmol/L、(5.0±1.1)mg/l、(297.5±7.0)pg/L,均明显高于对照组的(115.4±15.2)mmHg、(72.4±7.1)mmHg、(5.0±0.5)mmol/L、(4.6±0.6)%、(1.5±0.4)mmol/L、(2.3±0.5)mmol/L、(1.2±0.2)mg/l、(226.4±5.3)pg/L(均P<0.05);冠心病组、T2DM组、T2DM并冠心病组HDL-C水平为(0.9±0.1)mmol/L、(0.9±0.1)mmol/L、(0.8±0.1)mmol/L,明显低于对照组的(1.3±0.1)mmol/L(均P<0.05);T2DM组、T2DM并冠心病组FBG、HbAlc明显高于冠心病组(均P<0.05);T2DM并冠心病组收缩压、舒张压、FBG、HbAlc、TC、TG、LDL-C、Hs-CPR、Gas6明显高于冠心病组和T2DM组(均P<0.05),HDL-C明显低于冠心病组和T2DM组;T2DM并冠心病组的Gensini积分为(62.8±17.9)分,明显高于冠心病组的(23.7±4.9)分(P<0.05)。Pearson相关分析结果显示,Gas6水平与hs-CPR、Gensini积分均呈正相关(r=0.629、0.517,P<0.05)。多因素分析结果显示,hs-CRP、Gas6、HbAlc是T2DM并发冠心病的危险因素。结论Gas6在T2DM并发冠心病发生进展中发挥重要作用,且与冠状动脉病变程度密切相关,故检测T2DM患者或T2DM并发冠心病患者的血清Gas6水平对检测其病情变化有着重要临床意义。
Objective To investigate the change and significance of blood Gas 6 level in patients with type 2 diabetes mellitus complicated with coronary heart disease.Methods 89 patients with type 2 diabetes mellitus(T2DM group),85 patients with coronary heart disease(coronary heart disease group),and 88 patients with T2DM complicated with coronary heart disease(T2DM complicated with coronary heart disease group)were collected.At the same time,80 healthy persons matched by sex and age with case groups were selected as a control group.The levels of fasting blood glucose(FBG),glycosylated hemoglobin(HbAlc),total cholesterol(TC),triglyceride(TG),low or high density lipoprotein cholesterol(LDL-C or HDL-C),hypersensitive C-reactive protein(hs-CRP),and Gas6 were compared between the four groups.The relationship between Gas6 and other clinical indicators was analyzed.Multivariate regression analysis was made for coronary heart disease complicated with T2DM.Results The levels of SBP,DBP,FBG,HbAlc,TG,LDL-C,hs-CPR,Gas6 were(134.3±17.0)mmHg,(84.3±11.2)mmHg,(5.4±0.3)mmol/L,(4.9±0.7)%,(2.4±0.6)mmol/L,(2.8±0.6)mmol/L,(3.1±0.8)mg/l,and(280.2±6.9)pg/L in the coronary heart disease group,were(135.1±16.7)mmHg,(80.1±8.9)mmHg,(8.0±0.9)mmol/L,(7.8±0.9)%,(2.3±0.5)mmol/L,(2.8±0.5)mmol/L,(2.9±0.7)mg/L,and(275.1±6.7)pg/L in the T2DM group,and were(140.7±19.6)mmHg,(84.8±11.5)mmHg,(9.3±1.1)mmol/L,(9.1±1.4)%,(3.0±0.6)mmol/L,(3.0±0.6)mmol/L,(5.0±1.1)mg/l,and(297.5±7.0)pg/L in the T2DM complicated with coronary heart disease group;whice were significantly higher than those in the control group[(115.4±15.2)mmHg,(72.4±7.1)mmHg,(5.0±0.5)mmol/L,(4.6±0.6)%,(1.5±0.4)mmol/L,(2.3±0.5)mmol/L,(1.2±0.2)mg/l,and(226.4±5.3)pg/L);all P<0.05].The levels of HDL-C in the coronary heart disease group,the T2DM group,and the T2DM complicated with coronary heart disease group were(0.9±0.1)mmol/L,(0.9±0.1)mmol/L,and(0.8±0.1)mmol/L,which were significantly lower than that in the control group[(1.3±0.1)mmol/L].The FBG and HbAlc in the T2DM group and the T2DM complicated with coronary heart disease group were significantly higher than those in the coronary heart disease group(all P<0.05);the systolic blood pressure,diastolic blood pressure,FBG,HbAlc,TC,TG,LDL-C,hs-CPR,and Gas6 in the T2DM complicated with coronary heart disease group were significantly higher than those in the coronary heart disease group and those in the T2DM group(all P<0.05);the HDL-C in the T2DM complicated with coronary heart disease group was significantly lower than that in the coronary heart disease group and that in the T2DM group.The Gensini score in the T2DM complicated with coronary heart disease group was(62.8±17.9),which was significantly higher than that in the coronary heart disease group[(23.7±4.9),P<0.05)].Pearson correlation analysis showed that Gas6 level was positively correlated with hs-CPR and Gensini score(P<0.05).Multivariate analysis showed that hs-CRP,Gas6,and HbAlc were risk factors for coronary heart disease in patients with T2DM.Conclusion Gas2 plays an important role in the occurrence and progression of coronary heart disease in patients with T2DM,and is closely related to the degree of coronary artery disease.Therefore,the detection of serum Gas6 levels in patients with T2DM or patients with coronary heart disease complicated with T2DM has important clinical significance.
作者
张筱媛
王丽
Zhang Xiaoyuan;Wang Li(Department of Cardiovascular Medicine,Weihai Central Hospital,Weihai 264400,China)
出处
《国际医药卫生导报》
2019年第19期3247-3250,共4页
International Medicine and Health Guidance News
