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Title:: Glycosylated hemoglobin and serum lipid levels in diabetic patients with acute myocardial infarction

作者:: 胡莉华; 胡桃红; 靳志涛; 张丽娟; (解放军第二炮兵总医院心血管内科，北京 100088)

Author(s):: HU Lihua; HU Taohong; JIN Zhitao; ZHANG Lijuan; (Department of Cardiology, General Hospital, Second Artillery, Beijing, 100088, China)

关键词:: 心肌梗死; 急性; 糖尿病; 血脂; 糖化血红蛋白

Keywords:: myocardial infarction; diabetes; serum lipid; glycosylated hemoglobin

分类号:: R541.4

DOI:: -

文献标识码:: A

摘要:: 目的:探讨并发糖尿病的急性心肌梗死(AMI)患者糖化血红蛋白（HbA1c）和血脂异常的临床特点。方法:将临床确诊为AMI的132例患者按是否患有糖尿病分为糖尿病组（91例）和非糖尿病组（41例），同期住院的非糖尿病非冠心病患者32例为对照组，分析对比各组冠心病危险因素、HbA1c和血脂异常的特点。结果:对照组、糖尿病组和非糖尿病组在吸烟史、早发冠心病家族史、并发血脂异常、并发高血压比例上均无统计学意义。非糖尿病组患者的空腹血糖(FPG)显著高于对照组，但HbA1c(%)与对照组比较无差异。糖尿病组患者的FPG和HbA1c显著高于非糖尿病组。糖尿病组和非糖尿病组的总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A-Ⅰ(ApoA-Ⅰ)、载脂蛋白B(ApoB)水平均无显著差异，但糖尿病组患者TG和LDLC水平显著高于对照组。低HDL-C是二组患者检出率最高的血脂异常。结论:并发糖尿病的AMI患者血糖控制不佳，存在更明显的脂代谢异常，应重视冠心病患者糖化血红蛋白和血脂的检测和降糖、调脂治疗。

Abstract:: AIM:To compare the glycosylated hemoglobin (HbA1C) and serum lipid levels in diabetic patients with acute myocardial infarction (AMI) and nondiabetic AMI patients. METHODS: One hundred and thirtytwo AMI patients were divided into two groups: diabetic AMI group (n=92) and nondiabetic AMI group (n=41). Thirtytwo patients without AMI and diabetes served as the control group. Comparison was made in risk factors for coronary artery disease (CAD) and glycosylated hemoglobin and serum lipid levels. RESULTS: No significant difference was found in risk factors for CAD among the three groups. Compared with those in the nondiabetic AMI group and control group, fasting plasma glucose (FPG) levels and HbA1C were higher in diabetic AMI group (P<005). Triglyceride (TG) levels and lowdensity lipoprotein cholesterol (LDLC) were significantly higher in diabetic AMI group compared with those in control group. A high incidence of low HDLC level was the most common dyslipidemia in all three groups. CONCLUSION: Diabetic AMI patients have significantly higher levels of blood glucose, HbA1C and dyslipidemia. Prevention and treatment of high serum glucose and lipid may lower the occurrence of AMI.

参考文献/References

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急性心肌梗死并发糖尿病患者糖脂代谢特点分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

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