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目的:探讨2型糖尿病中血浆同型半胱氨酸(Hcy)水平对冠状动脉(冠脉)病变的影响。方法:将150例患者分为正常对照组(20例)、糖尿病不伴冠心病组(28例)、冠心病不伴糖尿病组(52例)及糖尿病合并冠心病组(50例),再根据冠脉造影将冠脉病变分为0、1、2和3支病变,采用单因素筛选和多因素分析得出糖尿病患者血浆Hcy水平与冠脉病变的关系。结果:冠心病伴或不伴糖尿病组血浆Hcy水平与正常对照组相比明显升高(P<0.01);糖尿病合并冠心病组血浆Hcy水平较冠心病不伴糖尿病组及糖尿病不伴冠心病组均显著增高(均P<0.05);糖尿病不伴冠心病组血浆Hcy水平与正常对照组比较,差异无统计学意义。多因素分析结果表明,Hcy是影响糖尿病合并冠心病患者冠脉病变程度的主要独立危险因素,而对非糖尿病患者冠脉病变程度影响不明显。另外,亚组分析显示糖尿病合并冠心病患者血浆Hcy越高,冠脉病变程度越重。结论:Hcy与糖尿病合并冠心病患者的冠脉病变程度具有明显相关性。
Objective: To investigate the effect of plasma homocysteine (Hcy) level on coronary artery (coronary artery) in type 2 diabetes mellitus (T2DM). Methods: 150 patients were divided into normal control group (20 cases), diabetes without coronary heart disease group (28 cases), coronary heart disease without diabetes group (52 cases) and diabetes combined with coronary heart disease group (50 cases) Coronary angiography coronary artery lesions were divided into 0, 1, 2 and 3 lesions, using single factor screening and multivariate analysis of plasma Hcy levels in diabetic patients and coronary artery disease. Results: Plasma homocysteine level in CHD patients with or without diabetes was significantly higher than that in controls (P <0.01). Hcy in patients with diabetes mellitus and coronary heart disease was significantly lower than those without diabetes and diabetes (All P <0.05). There was no significant difference in plasma homocysteine level between diabetic and non-coronary heart disease group compared with normal control group. Multivariate analysis showed that Hcy was the main independent risk factor affecting the degree of coronary artery disease in diabetic patients with coronary heart disease, but had no obvious effect on the degree of coronary artery disease in non-diabetic patients. In addition, subgroup analysis showed that the higher plasma Hcy in diabetic patients with coronary heart disease, the more severe coronary lesions. Conclusion: There is a significant correlation between Hcy and coronary artery disease in patients with diabetes complicated with coronary heart disease.