CAJ | 학술논문

目的：探讨谷胱甘肽系统对2型糖尿病（T2DM ）患者冠状动脉病变程度的影响。方法选取行冠状动脉造影术的患者236例，分为正常糖耐量（NGT ）组126例，T2DM组110例，检测患者的血液生化指标以及还原型谷胱甘肽（GSH）、GSH过氧化物酶（GSH-Px）和谷胱甘肽还原酶（GR）的活性。根据冠状动脉造影结果，采用Gensini评分系统对每支血管病变程度进行定量评分。结果 T2DM 组血浆GSH [（3．87±1．55）μg/L vs （4．45±1．94）μg/L]、GSH-Px[（0．29±0．05）ng/L vs （0．35±0．08）ng/L]和GR[（0．19±0．07）ng/L vs （0．26±0．08）ng/L]活性明显低于NGT组，差异有统计学意义（P＜0．05）。校正年龄、体重指数、血压、血脂、空腹血糖、空腹胰岛素、餐后2 h血糖、餐后2 h胰岛素、糖化血红蛋白因素后，T2DM 组GSH、GSH-Px、GR活性与Gensini积分呈负相关（P＜0.05，P＜0．01）。T2DM组GSH、GSH-Px和GR活性对Gensini积分的影响作用最大。结论 T2DM 患者血浆GSH、GR和GSH-Px活性的降低与冠状动脉病变程度具有一定的负相关性，且为该人群冠状动脉病变的独立影响因素。
목적：탐토곡광감태계통대2형당뇨병（T2DM ）환자관상동맥병변정도적영향。방법선취행관상동맥조영술적환자236례，분위정상당내량（NGT ）조126례，T2DM조110례，검측환자적혈액생화지표이급환원형곡광감태（GSH）、GSH과양화물매（GSH-Px）화곡광감태환원매（GR）적활성。근거관상동맥조영결과，채용Gensini평분계통대매지혈관병변정도진행정량평분。결과 T2DM 조혈장GSH [（3．87±1．55）μg/L vs （4．45±1．94）μg/L]、GSH-Px[（0．29±0．05）ng/L vs （0．35±0．08）ng/L]화GR[（0．19±0．07）ng/L vs （0．26±0．08）ng/L]활성명현저우NGT조，차이유통계학의의（P＜0．05）。교정년령、체중지수、혈압、혈지、공복혈당、공복이도소、찬후2 h혈당、찬후2 h이도소、당화혈홍단백인소후，T2DM 조GSH、GSH-Px、GR활성여Gensini적분정부상관（P＜0.05，P＜0．01）。T2DM조GSH、GSH-Px화GR활성대Gensini적분적영향작용최대。결론 T2DM 환자혈장GSH、GR화GSH-Px활성적강저여관상동맥병변정도구유일정적부상관성，차위해인군관상동맥병변적독립영향인소。
Objective To study the effect of glutathione (GSH)system on coronary artery lesion in type 2 diabetes mellitus (T2DM)patients .Methods Two hundred and thirty-six patients who un-derwent coronary angiography were divided into normal glucose tolerance (NGT ) group (n=126) and T2DM group (n= 110) .Their biochemical indexes were assayed and serum levels of GSH , GSH-Px and GR were meausred .Their coronary artery lesion was scored according to the Gensini scoring system .Results The serum levels of GSH ,GSH-Px and GR were significantly lower in T2DM group than in NGT group (3 .87 ± 1 .55 μg/L vs 4 .45 ± 1 .94 μg/L ,0 .29 ± 0 .05 ng/L vs 0.35 ± 0 .08 ng/L ,0 .19 ± 0 .07 ng/L vs 0 .26 ± 0 .08 ng/L ,P<0 .05) and negatively related with the Gensini score after adjustment for age ,BMI ,blood pressure ,blood lipids ,fasting glucose and insulin ,postprandial 2 h glucose and insulin ,HbA1c (P<0 .05 ,P<0 .01) ,indicating that the ser-um levels of GSH ,GSH-Px and GR could significantly influence the Gensini scores in T 2DM pa-tients .Conclusion Low serum levels of GSH ,GSH-PX and GR are negatively related with coro-nary artery lesion and are the independent factors for coronary artery lesion in T 2DM patients .