糖化血红蛋白水平与冠状动脉钙化斑块的相关性分析：基于OCT的研究

Correlation Analysis between Glycosylated Hemoglobin Levels and Calcified Coronary Plaques: An Optical Coherence Tomography Study

摘要: 目的：基于光学相干断层成像(optical coherence tomography, OCT)探讨糖化血红蛋白(glycosylated hemoglobin, HbA1c)水平与冠心病患者冠状动脉钙化斑块形态学特征的关系。方法：选取2014年1月至2019年1月所有于浙江大学医学院附属邵逸夫医院行OCT检查且存在钙化病变的冠心病患者81例。根据HbA1c水平分为高HbA1c组(HbA1c ≥ 6.5%) 20例及低HbA1c组(HbA1c < 6.5%) 61例，并对两组临床资料及OCT分析结果进行回顾性分析。结果：1) 除空腹血糖之外，两组临床资料比较均未见统计学差异；2) 高HbA1c组的最大钙化斑块弧度[(173.49˚ ± 110.71˚) vs. (123.21˚ ± 93.06˚), P = 0.049]、平均钙化斑块弧度[(88.84˚ ± 49.94˚) vs. (66.30˚ ± 40.32˚), P = 0.044]和总钙化指数[1402.14 (268.14, 2350.95) mm˚ vs. 307.57 (109.21, 988.46) mm˚, P = 0.016]明显高于低HbA1c组。3) Pearson相关分析显示，HbA1c与最大钙化弧度、平均钙化弧度、总钙化指数呈正相关。结论：对于冠心病患者来说，HbA1c水平在预测冠状动脉钙化病变严重程度方面具有潜在价值。

Abstract: Objectives: To investigate the relationship between glycosylated hemoglobin (HbA1c) and the morphological characteristics of coronary artery calcified plaques in patients with coronary heart disease (CHD) by optical coherence tomography (OCT). Methods: A total of 81 patients with calcified coronary lesions who undergone OCT scan at the Sir Run Run Shaw Hospital affiliated to the Medical College of Zhejiang University between January 2014 and January 2019 were selected. Patients were divided into two groups according to the level of HbA1c: High-HbA1c group (HbA1c ≥ 6.5%, n = 20) and Low-HbA1c group (HbA1c < 6.5%, n = 61). The clinical characteristics and OCT findings were retrospectively analyzed. Results: 1) There were no statistical difference in clinical characteristics between the two groups, to the exception of fasting glucose. 2) The maximal calcium arc [(173.49˚ ± 110.71˚) vs. (123.21˚ ± 93.06˚), P = 0.049], average calcium arc [(88.84˚ ± 49.94˚) vs. (66.30˚ ± 40.32˚), P = 0.044], and total calcium index [1402.14 (268.14, 2350.95) mm˚ vs. 307.57 (109.21, 988.46) mm˚, P = 0.016] were significantly higher in High-HbA1c group than those in Low-HbA1c group. 3) Pearson correlation analysis revealed that HbA1c levels were positively correlated with maximal calcium arc, average calcium arc and total calcium index. Conclusion: For patients with CHD, HbA1c has a potential value for predicting the severity of calcified coronary lesions.