郭治国,何立芸,郭丽君,张永珍,张福春,牛杰,王贵松,韩江莉,崔鸣,高炜

• 1:北京大学第三医院急诊科
• 2:北京大学第三医院心内科

摘要(Abstract)：

目的分析存在冠状动脉病变的患者空腹血糖水平与冠状动脉病变复杂程度的关系。方法回顾性收集2009年1月至2011年1月于北京大学第三医院疑诊为冠心病并行冠状动脉造影(CAG)证实存在冠状动脉病变的929例患者的临床和CAG资料。根据SYNTAX积分对患者进行分组,应用双变量相关分析,多元逐步回归分析和Logistic回归分析空腹血糖水平与冠状动脉SYNTAX积分之间的相关性。结果①929例患者中,以SYNTAX积分分为:低危组(积分<22分)47例,中危组(22分≤积分<33分)189例,高危组(积分≥33分)693例。组间比较显示,患者年龄、空腹血糖水平、空腹血糖异常和既往糖尿病患者比例,差异具有统计学意义。②相关分析提示,SYNTAX积分与空腹血糖呈相关性(r=0.167,P=0.000)。亚组分析则显示,仅在无糖尿病史患者中,SYNTAX积分与空腹血糖之间存在相关性(r=0.149,P=0.000);而在既往糖尿病史患者中,两者不具有相关性。③多元逐步回归分析显示,空腹血糖水平与SYNTAX积分独立相关(β=0.452,P=0.002)。亚组分析显示,仅在既往无糖尿病史亚组中,空腹血糖水平与SYNTAX积分独立相关(β=1.039,P=0.000)。④将SYNTAX中危组和高危组合并为中高危组,以SYNTAX积分作为因变量,以性别、年龄、高血压、糖尿病、高脂血症、吸烟、空腹血糖为自变量,进行Logistic回归分析,在整组和无糖尿病史亚组中均筛选出两个变量即:年龄(整组OR 1.033,95%CI 1.017~1.049,P=0.000;无糖尿病史组OR 1.039,95%CI 1.020~1.059,P=0.000)和空腹血糖水平(整组OR 1.114,95%CI 1.038~1.195,P=0.003;无糖尿病史组OR 1.299,95%CI 1.088~1.387,P=0.001)。结论存在冠状动脉病变的患者空腹血糖水平可能反映冠状动脉病变的复杂程度,具有预测中高SYNTAX积分的作用,尤其适用于无糖尿病史患者。

关键词(KeyWords)： 空腹血糖;冠状动脉造影;冠状动脉病变;SYNTAX积分

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 郭治国,何立芸,郭丽君,张永珍,张福春,牛杰,王贵松,韩江莉,崔鸣,高炜

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