冠心病合并糖尿病患者外周血巨噬细胞中脂质稳态与动脉粥样硬化指数的关联研究

摘要 目的：探究冠心病合并糖尿病患者外周血巨噬细胞中脂质稳态与动脉粥样硬化指数的关联机制。方法：2015年1月至2020年9月，筛选78名2型冠心病合并糖尿病患者，根据血糖变异度分为3组：A组、B组及C组。检测总胆固醇（TC），甘油三酯（TG），低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、空腹胰岛素（FINS）和超敏C反应蛋白（hs-CRP）。评估动脉粥样硬化指数（AI）和冠状动脉狭窄程度，并分析其相关性及独立危险因素。结果：B组较A组TC、LDL-C和AI升高，HDL-C降低，B组较C组TC、LDL-C和AI降低，HDL-C升高（P<0.05）。B组较A组hs-CRP、FINS、TG值升高，B组较C组hs-CRP、FINS、TG值降低（P<0.05）。B组较A组HOMA-IR值升高，B组较C组HOMA-IR值降低（P<0.05）。B组较A组AI和冠脉Gensini评分值升高，B组较C组AI和冠脉Gensini评分降低（P<0.05）。Person线性相关分析显示：hs-CRP、TG、Gensini评分、HOMA-IR值与AI正相关（P<0.05）。在逻辑回归模型中，结果显示：hs-CRP、TG、Gensini评分、HOMA-IR值是AI的独立危险因素。结论：Gensini评分与AI呈正相关，且hs-CRP、TG、Gensini评分、HOMA-IR值AI的独立危险因素。

Relationship between Lipid Homeostasis in Peripheral Blood Macrophages and Atherosclerosis Index in Patients with Coronary Heart Disease Complicated with Diabetes Mellitus

ABSTRACT Objective: To explore the correlation mechanism between lipid homeostasis and atherosclerosis index in peripheral blood macrophages of patients with diabetes and coronary heart disease. Methods: From January 2015 to September 2020, 78 patients with type 2 CHD complicated with diabetes were screened and divided into 3 groups according to blood glucose variability: group A, group B and group C. TC, TG, LDL-C, HDL-C, FINS and HS-CRP were detected. Atherosclerosis index (AI) and severity of coronary artery stenosis were evaluated, and their correlation and independent risk factors were analyzed. Results: TC, LDL-C and AI were increased and HDL-C was decreased in group B compared with group A, while TC, LDL-C and AI were decreased and HDL-C was increased in group B compared with group C (P<0.05). hs-CRP, FINS and TG values in group B were higher than those in group A, while hs-CRP, FINS and TG values in group B were lower than those in group C (P<0.05). Homa-ir value in group B was higher than that in group A, and homA-IR value in group B was lower than that in group C (P<0.05). AI and coronary Gensini scores in group B were higher than those in group A, while AI and coronary Gensini scores in group B were lower than those in group C (P<0.05). Person linear correlation analysis showed that hs-CRP, TG, Gensini score and HOMA-IR values were positively correlated with AI (P<0.05). In logistic regression model, the results showed that HS-CRP, TG, Gensini score and HOMA-IR were independent risk factors for AI (P<0.05). Conclusion: Gensini score was positively correlated with AI, and hS-CRP, TG, Gensini score and HOMA-IR value were independent risk factors for AI.