天津医药

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糖基化血红蛋白不同组分对冠心病的临床价值

刘军锋1,孔美娟2,贾克刚3,刘运德2   

  1. 1. 天津泰达国际心血管病医院 天津医科大学心血管病临床学院检验科
    2. 天津医科大学医学检验学院
    3. 天津泰达国际心血管病医院
  • 收稿日期:2012-10-24 修回日期:2013-06-29 出版日期:2013-10-15 发布日期:2013-10-15
  • 通讯作者: 刘军锋

The Clinical Value of the Different Components of Glycosylated Hemoglobin in Patients with Coronary Artery Disease

LIU Jun feng1,KONG Mei juan2,JIA Ke gang1,LIU Yun de2   

  1. 1. Department of Laboratory,TEDA International Cardiovascular Hospital(Cardiovascular Disease Clinical College of Tianjin Medical University)
    2. College of Medical Laboratory Sciences of Tianjin Medical University
  • Received:2012-10-24 Revised:2013-06-29 Published:2013-10-15 Online:2013-10-15
  • Contact: LIU Jun feng

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摘要：

【摘要】  目的  探讨糖基化血红蛋白不同组分对冠心病发病的临床价值。 方法  217例患者分为冠心病组（Ⅰ组，60例），冠心病非急性冠脉综合征（ACS）合并糖尿病组（Ⅱ组，60例），ACS合并糖尿病组（Ⅲ组，97例）3组，同期58例健康体检者为对照组。检测果糖糖化血红蛋白（HbA1a）、乳糖糖化血红蛋白（HbA1b）、葡萄糖糖化血红蛋白（HbA1c）、血红蛋白P3组分（HbP3）、血红蛋白A0组分（HbA0）、不稳定糖化血红蛋白（LA1c/CHb1）和抗碱血红蛋白（HbF），并对各组参数进行比较。应用Logistic回归分析冠心病及冠心病合并糖尿病的影响因素，并采用ROC曲线分析比较各影响因素的诊断效能。  结果  Ⅰ组、Ⅱ组与Ⅲ组的HbA1b、HbA1c、HbP3和HbA0与对照组比较差异有统计学意义（P<0.01或P<0.05），Ⅱ组与Ⅲ组比较，糖基化血红蛋白各参数差异f无统计学意义（P>0.05）。Logistic逐步回归及ROC曲线分析显示，HbA1c、HbP3是冠心病的影响因素且具有一定的诊断效能。HbA1c、HbP3在Ⅱ组、Ⅲ组的ROC曲线效能基本一致。  结论  HbA1b、HbA1c、HbP3和HbA0与冠心病及冠心病合并糖尿病关系密切。HbA1c和HbP3是冠心病的影响因素且具有一定的诊断效能

关键词: 血红蛋白A, 糖基化, 冠心病, 乳糖糖化血红蛋白, 葡萄糖糖化血红蛋白, 血红蛋白P3组分, 血红蛋白A0组分

Abstract:

 [Abstract]   Objective   To explore the clinical value of the different components of glycosylated hemoglobin in pa-
tients with coronary artery disease (CAD).   Methods   A total of217patients were divided into3groups: CAD group (groupⅠ,n=60), CAD patients without acute coronary syndrome (ACS) and with diabetes mellitus group (groupⅡ, n=60) and ACSpatients with diabetes mellitus group (group Ⅲ,n=97). Fifty-eight healthy volunteers in the same time period were selected as control group. The values of fructose glycosylated hemoglobin (HbA1a), lactose glycosylated hemoglobin (HbA1b), glucose glycosylated hemoglobin (HbA1c), hemoglobin P3component (HbP3), hemoglobin A0component (HbA0), unstable glycosylated hemoglobin (LA1c/CHb1) and alkali-resistant hemoglobin (HbF) were measured. These parameters were compared between4groups. Logistic regression was used to analyze factors that influencing CAD and CAD with diabetes mellitus. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of these factors.  Results  There were significant differences in titers of HbA1b, HbA1c, HbP3and HbA0between groupⅠ, groupⅡ, group Ⅲ and control group (P<0.01, or P<0.05). There were no significant differences in levels of glycosylated hemoglobin parameters between group Ⅱ and group Ⅲ (P>0.05). Logistic regression and ROC curve analysis showed that HbA1c and HbP3were independent effects of CAD, and there were some diagnostic efficiency of CAD. The diagnostic efficiency of ROC curve was consistent in HbA1c and HbP3between group Ⅱ and group Ⅲ.  Conclusion   Levels of HbA1b, HbA1c, HbP3and HbA0are closely related to CAD and CAD with diabetes mellitus. HbA1c and HbP3are independent effects of CAD and, there are some diagnostic efficiency in CAD.

Key words: hemoglobin A, glycosylated, Coronary disease, HbA1b, HbA1c, HbP3, HbA0