中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
4期
10-14
,共5页
张春元%张春梅%刘兰霞%王萌%童雨田%王慎田
張春元%張春梅%劉蘭霞%王萌%童雨田%王慎田
장춘원%장춘매%류란하%왕맹%동우전%왕신전
糖尿病,2型%骨保护素%冠状动脉疾病
糖尿病,2型%骨保護素%冠狀動脈疾病
당뇨병,2형%골보호소%관상동맥질병
Diabetes mellitus,type 2%Osteoprotegerin%Coronary disease
目的 研究2型糖尿病并冠心病患者血清护骨素(OPG)水平的变化以及血清OPG水平与冠心病严重程度之间的关系.方法 选择2型糖尿病并冠心病患者108例(糖尿病并冠心病组),其中急性冠状动脉综合征68例,稳定型心绞痛40例.选择年龄、性别相匹配的无血管并发症的2型糖尿病患者60例(糖尿病非冠心病组)及40例健康体检者(对照组).应用酶联免疫吸附试验法测定各组血清OPG水平.结果 糖尿病并冠心病组血清OPG水平(4.12±0.71) ng/L,显著高于糖尿病非冠心病组的(2.69±0.52) ng/L和对照组的(2.14±0.37) ng/L,差异有统计学意义(P＜ 0.05或＜ 0.01).糖尿病并冠心病组中,急性冠状动脉综合征患者血清OPG水平(4.56±0.92) ng/L,显著高于稳定型心绞痛患者的(3.61±0.76) ng/L,差异有统计学意义(P＜0.05).Gensini积分＞40分患者(41例)血清OPG水平为(4.92±0.89) ng/L,显著高于Gensini积分20～40分患者(53例)的(4.08±0.75) ng/L和Gensini积分＜20分患者(14例)的(3.39±0.85) ng/L,差异有统计学意义(P＜ 0.01或＜0.05),而且Gensini积分20～40分患者血清OPG水平高于Gensini积分＜20分患者,差异有统计学意义(P＜ 0.05).单支病变(16例)、双支病变(57例)及三支病变(35例)患者血清OPG水平[(3.52±0.82)、(4.54±0.68)、(4.75±0.93) ng/L]与对照组比较差异有统计学意义(P＜0.05);双支病变、三支病变患者血清OPG水平显著高于单支病变患者,差异有统计学意义(P＜0.05);三支病变患者与双支病变患者血清OPG水平比较差异无统计学意义(P＞0.05).Logistic回归分析结果显示糖化血红蛋白、总胆固醇、超敏C反应蛋白和OPG是2型糖尿病并冠心病的独立危险因素.结论 2型糖尿病并冠心病患者血清OPG水平显著高于无血管并发症者,而且血清OPG水平与冠心病的严重程度有关,血清OPG水平是2型糖尿病并冠心病的独立影响因素.
目的 研究2型糖尿病併冠心病患者血清護骨素(OPG)水平的變化以及血清OPG水平與冠心病嚴重程度之間的關繫.方法 選擇2型糖尿病併冠心病患者108例(糖尿病併冠心病組),其中急性冠狀動脈綜閤徵68例,穩定型心絞痛40例.選擇年齡、性彆相匹配的無血管併髮癥的2型糖尿病患者60例(糖尿病非冠心病組)及40例健康體檢者(對照組).應用酶聯免疫吸附試驗法測定各組血清OPG水平.結果 糖尿病併冠心病組血清OPG水平(4.12±0.71) ng/L,顯著高于糖尿病非冠心病組的(2.69±0.52) ng/L和對照組的(2.14±0.37) ng/L,差異有統計學意義(P＜ 0.05或＜ 0.01).糖尿病併冠心病組中,急性冠狀動脈綜閤徵患者血清OPG水平(4.56±0.92) ng/L,顯著高于穩定型心絞痛患者的(3.61±0.76) ng/L,差異有統計學意義(P＜0.05).Gensini積分＞40分患者(41例)血清OPG水平為(4.92±0.89) ng/L,顯著高于Gensini積分20～40分患者(53例)的(4.08±0.75) ng/L和Gensini積分＜20分患者(14例)的(3.39±0.85) ng/L,差異有統計學意義(P＜ 0.01或＜0.05),而且Gensini積分20～40分患者血清OPG水平高于Gensini積分＜20分患者,差異有統計學意義(P＜ 0.05).單支病變(16例)、雙支病變(57例)及三支病變(35例)患者血清OPG水平[(3.52±0.82)、(4.54±0.68)、(4.75±0.93) ng/L]與對照組比較差異有統計學意義(P＜0.05);雙支病變、三支病變患者血清OPG水平顯著高于單支病變患者,差異有統計學意義(P＜0.05);三支病變患者與雙支病變患者血清OPG水平比較差異無統計學意義(P＞0.05).Logistic迴歸分析結果顯示糖化血紅蛋白、總膽固醇、超敏C反應蛋白和OPG是2型糖尿病併冠心病的獨立危險因素.結論 2型糖尿病併冠心病患者血清OPG水平顯著高于無血管併髮癥者,而且血清OPG水平與冠心病的嚴重程度有關,血清OPG水平是2型糖尿病併冠心病的獨立影響因素.
목적 연구2형당뇨병병관심병환자혈청호골소(OPG)수평적변화이급혈청OPG수평여관심병엄중정도지간적관계.방법 선택2형당뇨병병관심병환자108례(당뇨병병관심병조),기중급성관상동맥종합정68례,은정형심교통40례.선택년령、성별상필배적무혈관병발증적2형당뇨병환자60례(당뇨병비관심병조)급40례건강체검자(대조조).응용매련면역흡부시험법측정각조혈청OPG수평.결과 당뇨병병관심병조혈청OPG수평(4.12±0.71) ng/L,현저고우당뇨병비관심병조적(2.69±0.52) ng/L화대조조적(2.14±0.37) ng/L,차이유통계학의의(P＜ 0.05혹＜ 0.01).당뇨병병관심병조중,급성관상동맥종합정환자혈청OPG수평(4.56±0.92) ng/L,현저고우은정형심교통환자적(3.61±0.76) ng/L,차이유통계학의의(P＜0.05).Gensini적분＞40분환자(41례)혈청OPG수평위(4.92±0.89) ng/L,현저고우Gensini적분20～40분환자(53례)적(4.08±0.75) ng/L화Gensini적분＜20분환자(14례)적(3.39±0.85) ng/L,차이유통계학의의(P＜ 0.01혹＜0.05),이차Gensini적분20～40분환자혈청OPG수평고우Gensini적분＜20분환자,차이유통계학의의(P＜ 0.05).단지병변(16례)、쌍지병변(57례)급삼지병변(35례)환자혈청OPG수평[(3.52±0.82)、(4.54±0.68)、(4.75±0.93) ng/L]여대조조비교차이유통계학의의(P＜0.05);쌍지병변、삼지병변환자혈청OPG수평현저고우단지병변환자,차이유통계학의의(P＜0.05);삼지병변환자여쌍지병변환자혈청OPG수평비교차이무통계학의의(P＞0.05).Logistic회귀분석결과현시당화혈홍단백、총담고순、초민C반응단백화OPG시2형당뇨병병관심병적독립위험인소.결론 2형당뇨병병관심병환자혈청OPG수평현저고우무혈관병발증자,이차혈청OPG수평여관심병적엄중정도유관,혈청OPG수평시2형당뇨병병관심병적독립영향인소.
Objective To investigate the change of serum osteoprotegerin level and relationships between serum osteoprotegerin level and coronary heart disease (CHD) in patients with type2 diabetes mellitus (DM) complicated with CHD.Methods One hundred and eight patients with type 2 DM complicated with CHD were selected as DM with CHD group,including 68 cases with acute coronary syndrome and 40 cases with stable angina pectoris.In addition,60 type 2 DM patients without CHD (DM without CHD group) and 40 healthy people (control group) were selected.Serum osteoprotegerin level was measured by enzyme linked immunosorbent assay.Results The serum osteoprotegerin level in DM with CHD group was significantly higher than that in DM without CHD group and control group [(4.12 ± 0.71)ng/L vs.(2.69 ± 0.52) and (2.14 ± 0.37) ng/L],and there were statistical differences (P＜ 0.05 or ＜ 0.01).In DM with CHD group,the serum osteoprotegerin level in acute coronary syndrome was significantly higher than that in stable angina pectoris [(4.56 ±0.92) ng/L vs.(3.61 ±0.76) ng/L],and there was statistical difference (P ＜ 0.05).The serum osteoprotegerin level in patients with Gensini score ＞ 40 scores (41 cases)was significantly higher than that in patients with Gensini score 20-40 scores (53 cases) and patients with Gensini score ＜ 20 scores (14 cases) [(4.92 ± 0.89) ng/L vs.(4.08 ± 0.75) and (3.39 ± 0.85) ng/L],and there were statistical differences (P ＜ 0.01 or ＜ 0.05).The serum osteoprotegerin level in patients with Gensini score 20-40 scores was significantly higher than that in patients with Gensini score ＜ 20 scores,and there was statistical difference (P ＜0.05).The serum osteoprotegerin level in single-vessel lesion (16 cases),double-vessel lesion (57 cases) and three-vessel lesion (35 cases) [(3.52 ± 0.82),(4.54 ± 0.68),(4.75 ±0.93) ng/L] were significantly higher than those in control group,and there were statistical differences (P ＜ 0.05); and the serum osteoprotegerin level in double-vessel lesion and three-vessel lesion were significantly higher than those in single-vessel lesion,and there were statistical differences (P ＜ 0.05) ;there was no statistical difference between three-vessel lesion and double-vessel lesion(P＞ 0.05).The results of Logistic regression analysis showed that glycosylated hemoglobin,total cholesterol,high sensitivity C reactive protein and osteoprotegerin were independent risk factors of type 2 DM complicated with CHD.Conclusions Serum osteoprotegerin level in patients with type 2 DM complicated with CHD is significantly increased.There is a significant association between serum osteoprotegerin level and the presence and severity of CHD,and the serum osteoprotegerin level is independent risk factors of type 2 DM complicated with CHD.
