肖春洁

[摘要]目的 探討糖化血红蛋白（HbA1c）及血脂在糖尿病合并冠心病中的检测意义。方法 选择2015年6月～2016年6月就诊于本院内分泌科的2型糖尿病患者共185例，其中98例2型糖尿病合并冠心病患者作为合并症组，87例单纯性2型糖尿病患者作为糖尿病组，再选取同期于本院进行体检的60例健康人作为对照组。然后对三组患者TC、TG、LDL-C、HDL-C、APOA-I、APOB、HbA1c的水平进行统计分析。从185例2型糖尿病患者中随机选出80例，将入院时空腹血糖水平≥11.10 mmol/L作为A组，7.0 mmol/L≤空腹血糖水平<11.10 mmol/L作为B组，然后分析血糖与血脂之间的关系。结果 糖尿病组与合并症组TC、TG、LDL-C、APOB及HbA1c的检测水平明显高于对照组（P<0.05）；HDL-C和APOA-Ⅰ的检测水平明显低于对照组（P<0.05）；合并症组TG、HDL-C及HbA1c的检测水平与糖尿病组比较，差异有统计学意义（P<0.05）。A组患者TG含量明显高于B组[（2.76±1.32）mmol/L vs. （1.93±1.06）mmol/L]（P<0.05），APOB水平较B组高[（1.34±0.19）g/L vs. （1.18±0.23）g/L]，差异有统计学意义（P<0.05）。结论 TG、HDL-C及HbA1c是2型糖尿病患者并发冠心病的预测指标；血糖水平越高的患者越易出现脂类代谢异常，越易造成血管内皮功能损伤，所以临床上严格控制2型糖尿病患者的血糖、血脂水平，能够对延缓、预防冠心病的发生起到重要作用。

[关键词]2型糖尿病；冠心病；糖化血红蛋白；血脂；载脂蛋白

[中图分类号] R587.2 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0129-03

[Abstract]Objective To investigate significance of glycosylated hemoglobin and serum lipids detection in patients with diabetes mellitus complicated with coronary heart disease.Methods A total of 185 patients with type 2 diabetes mellitus in Department of Endocrinology of the hospital were selected from June 2015 to June 2016.Among them，98 patients with type 2 diabetes mellitus complicated with coronary heart disease were selected as complication group and 87 patients with simple type 2 diabetes mellitus as diabetes group，and then 60 healthy people for physical examination at the same period in the hospital were selected as control group.The levels of TC，TG，LDL-C，HDL-C，APOA-I，APOB，HbA1c were analyzed statistically.80 patients were randomly selected from 185 patients with type 2 diabetes mellitus，the fasting blood glucose level≥11.10 mmol/L was taken as group A，7.0 mmol/L≤fasting blood glucose level <11.10 mmol/L as group B，relationship between blood glucose and blood lipid was analyzed.Results The level of TC，TG，LDL-C，APOB and HbA1c in the diabetic group and the complication group was significantly higher than that in the control group；the levels of HDL-C and APOA-Ⅰ was significantly lower than that in the control group；the levels of TG，HDL-C and HbA1c in the complication group was significantly higher than that in the diabetic group，there was significant difference between two groups （P<0.05）.The levels of TG in group A was significantly higher than that in group B [（2.76±1.32）mmol/L vs. （1.93±1.06）mmol/L]（P<0.05）.APOB was significantly higher than that in group B [（1.34±0.19）g/L vs. （1.18±0.23）g/L]，there was significant difference（P<0.05）.Conclusion TG，HDL-C and HbA1c are the predictors of the development of type 2 diabetes mellitus patients with coronary heart disease.The patients with higher blood glucose levels are more prone to abnormal lipid metabolism，which may lead to vascular endothelial dysfunction.Therefore，strict control of type 2 diabetic patients mellitus with blood glucose，blood lipid levels，can play an important role in delaying and preventing coronary heart disease.

[Key words]Type 2 diabetes；Coronary heart disease；Glycated hemoglobin；Lipids；Apolipoprotein

糖尿病是一種以血糖水平上升为主要临床特征的内分泌代谢性疾病。根据国际糖尿病联盟统计，在2000年全球约有糖尿病患者1.51亿人次，按此趋势发展未来30年糖尿病人群将上升至5亿[1]。在糖尿病初期症状常不明显，不能引起患者的重视从而导致病情发展，进而引发循环系统疾病、肾病等诸多并发症的发生，且不可逆，其中并发心脑血管疾病是造成患者死亡的关键原因[2]。因此平素需加强群众对糖尿病的认识，提高本病的预防意识。在临床诊疗过程中应当重视糖尿病并发症的有效预防和治疗，帮助患者提高生活质量、延长生存期。糖尿病患者长时间处在高血糖状态，并存在脂质代谢的异常，与冠心病的发生存在一定联系[3-4]。故笔者通过检测2型糖尿病患者的糖化血红蛋白（HbA1c）及血脂水平，来探讨其与冠心病发生的关系。

1资料与方法

1.1一般资料