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纸质出版:2014
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闫庆凯,邓宜鹂,方慧,王旭开.2型糖尿病合并冠心病患者血清γ谷氨酰胺转移酶与冠脉病变严重程度的相关性[J].陆军军医大学学报(原第三军医大学学报),2014,36(15):1610-1613.
Yan Qingkai,Deng Yili,Fang Hui,Wang Xukai.Correlation of serum gamma glutamine transferase with coronary artery culprit lesions in type 2 diabetic patients with coronary artery diseases[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(15):1610-1613.
闫庆凯,邓宜鹂,方慧,王旭开.2型糖尿病合并冠心病患者血清γ谷氨酰胺转移酶与冠脉病变严重程度的相关性[J].陆军军医大学学报(原第三军医大学学报),2014,36(15):1610-1613. DOI:
Yan Qingkai,Deng Yili,Fang Hui,Wang Xukai.Correlation of serum gamma glutamine transferase with coronary artery culprit lesions in type 2 diabetic patients with coronary artery diseases[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(15):1610-1613. DOI:
目的 探讨2型糖尿病合并冠心病患者血清γ谷氨酰胺转移酶(gamma glutamine transferase,GGT)与冠脉病变严重程度的相关性,研究血清GGT的升高在冠心病评估中的重要意义。 方法 选取在我院接受冠状动脉造影的2型糖尿病患者226例为研究对象,选择性冠脉造影后根据有无冠脉病变分成冠脉病变组和冠脉正常组。计算冠脉病变组的Gensini积分;测定两组患者的血清GGT及其他致冠心病危险因素水平[体质量指数(BMI)、低密度脂蛋白胆固醇(LDL-c)、胰岛素C肽等
]
,分析GGT及其他危险因素与Gensini积分的相关性。 结果 226例患者中,冠脉病变组的年龄、BMI、LDL-c、高密度脂蛋白胆固醇(HDL-c)、GGT、胰岛素C肽、Gensini积分与冠脉正常组比较差异有统计学意义(
P
0.05),而其他因素如性别、空腹血糖值(Glu)、糖化血红蛋白(HbA1c)、收缩压、舒张压、总胆固醇(TC)、甘油三酯(TG)、血清谷草转氨酶(AST)、血清谷丙转氨酶(ALT)、血清肌酐(Scr)、血清白蛋白(ALB)比较差异则无统计学意义。根据Gensini积分将患者分成低分组(20分)、中分组(20~40分)、高分组(40分)3个亚组,并将冠脉正常组作对照组,冠脉病变患者各亚组GGT与正常对照组有统计学差异(
P
0.01),而胰岛素C肽则仅为高分组与正常对照组有统计学差异(
P
0.01)。在冠脉病变组,高分组患者的GGT、胰岛素C肽显著高于低分组、中分组患者(
P
0.01)。相关分析显示,在2型糖尿病合并冠心病患者中,LDL-c与血清GGT水平及冠脉狭窄程度积分呈正相关,相关系数分别为(r=0.373,
P
0.01)和(r=0.264,
P
0.01)。ROC曲线分析结果显示GGT的面积为0.674(0.598~0.750),仅低于BMI(0.703)、LDL-c(0.687),而高于年龄(0.640)、胰岛素C肽(0.592)、HDL-c(0.379)。 结论 2型糖尿病合并冠心病患者的血清GGT水平与其冠脉病变程度呈正相关,可作为预测冠脉风险的独立评价指标,尤其是在医疗检验手段落后的区县医院更具有指导意义。
Objective To investigate the correlati
on of serum level of gamma glutamine transferase (GGT) with the severity of coronary artery lesions in patients with type 2 diabetes accompanied with coronary artery diseases (CHD) and explore the significance of serum GGT in evaluation of CHD. Methods A total of 226 patients with type 2 diabetes who receiving coronary angiography in our hospital from March 2012 to March 2013 were recruited in this study. These patients were divided into coronary lesions group calculated with the Gensini score) and normal coronary artery group according to the results of selective coronary angiography. The serum level of GGT was measured
and other risk factors and components of CHD
such as body mass index (BMI)
low-density lipoprotein cholesterol (LDL-c)
and insulin-C peptide were also detected. Results Among these 226 patients
there were statistical significance in the age
BMI
LDL-c
HDL-c
GGT
insulin-C peptide and Gensini score between the coronary lesion group and normal coronary artery group (
P
0.05)
while there was no difference in other factors such as gender
Glu
systolic pressure
diastolic pressure
TC
TG
AST
ALT
serum creatinine
serum albumin between them. According to the level of the Gensini score
the coronary lesion group were further divided into 3 subgroups
i.e.
the high (40)
middle (20 to 40)
and low (20) score groups
and the normal coronary group was employed for comparative analysis. The GGT level of all subgroups and normal control group was statistically difference (
P
0.01)
whereas for the insulin-C peptide
only the high group and normal control group had statistically significant (
P
0.01). What′s more
both levels of GGT and insulin-C peptide were significantly higher in the high score group than in the middle and low score groups (
P
0.01). In the type 2 diabetic patients with coronary artery disease
the levels of plasma LDL-c and serum GGT were positively correlated with the coronary artery narrow degree (r=0.373,
P
0.01; r=0.26
4,
P
0.01). In ROC curve analysis
the area under curve (AUC) for GGT was 0.674 (ranged 0.598 to 0.750) for coronary lesion group
significantly lower than that of BMI (0.703)
LDL-c (0.687)
and higher than that of age (0.640)
insulin-C peptide (0.592)
and HDL-c (0.379). Conclusion The serum level of GGT is positively associated with the degree of coronary artery lesions in patients with type 2 diabetes mellitus and coronary heart disease
and can be used as an independent predictor of coronary risk.
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