中成药联合西药治疗冠心病心绞痛患者在不同空腹血糖水平下糖化血红蛋白与心功能的相关性分析

The correlation analysis of Chinese patent medicine combined with western medicine treatment on coronary heart disease between glycation hemoglobin and heart function in patients with coronary angina at different glucose levels

关键词:  冠心病心绞痛  糖代谢  心功能  中成药

Key words:  coronary heart disease  glucose metabolism  cardiac function  Chinese patent medicine

摘要:

[目的] 探讨中成药联合西药治疗对冠心病心绞痛患者不同空腹血糖（FPG）水平下糖化血红蛋白（HbA1c）及心功能相关指标的影响，以及FPG、HbA1c与心功能的相关性。[方法] 选取冠心病心绞痛患者2 959例，按照是否服用中成药分为暴露组和非暴露组，通过倾向性评分匹配调整基线数据差异，研究两组FPG、HbA1c与心功能指标的差异性。将患者根据FPG四分位分组，分析HbA1c与心功能指标的差异性。分析糖代谢水平与心功能指标的相关性，以左心室收缩功能异常发生率（是/否）为因变量，将患者是否服用中成药、性别、年龄、HbA1c、FPG作为自变量进行二元Logistic回归分析。[结果] 暴露组与非暴露组FPG、HbA1c、二尖瓣流速E（E）、二尖瓣流速A（A）差异有统计学意义（P<0.01）。FPG分组后，Q3水平左心室射血分数（LVEF）、Q4水平左室舒张末期前后径（LVED）、LVEF、E在两组间差异有统计学意义（P<0.05）。FPG、HbA1c与心功能指标相关性分析结果显示HbA1c、FPG、LVED、A两两之间呈正相关性（P<0.05），HbA1c、FPG与LVEF呈负相关性（P<0.05），HbA1c与二尖瓣流速E/二尖瓣流速A（E/A）呈显著负相关性（P<0.01）。经回归分析预测左心室收缩功能异常的发生率与是否服用中成药、性别、HbA1c有关。[结论] FPG、HbA1c与心功能显著相关，中成药联合西药治疗冠心病心绞痛可有效降低患者的FPG、HbA1c，在FPG较高水平下，中成药联合西药治疗对于患者LVED、LVEF改善明显。中成药联合西药治疗冠心病可降低患者左心室收缩功能异常的发生率。

Abstract:

[Objective] To explore the effect of Chinese patent medicine combined with western medicine treatment on HbA1c and related indexes of cardiac function under different fasting plasma glucose levels in patients with coronary heart disease and angina pectoris as well as the correlation among FPG,HbA1c and cardiac function. [Methods] The 2 959 patients of coronary heart disease and angina pectoris were selected and divided into exposed and non-exposed groups according to whether or not to take traditional Chinese medicine. A propensity score-matched analysis was done to adjust baseline data differences and study the differences of FPG,HbA1c and cardiac function indexes between the two groups. The patients were grouped according to FPG quartiles,and the differences between HbA1c and cardiac function indexes in the four groups were analyzed. By analyzing the correlation between the patient's glucose metabolism level and cardiac function indicators,taking the incidence of abnormal left ventricular systolic function as the dependent variable,and whether the patient was taking Chinese patent medicine adjuvant therapy,this paper studying binary logistic regression analysis on gender,age,HbA1c,FPG as independent variables. [Results] The FPG,HbA1c,Pand E velocity of mieral flow(E),Pand A velociey of mitron flow(A) value difference between exposed group and non-exposed group was statistically significant (P<0.01). Grouping by FPG,LVEF value in Q3 the LVED,LVEF,and E values in Q4 had statistically significant differences between the two groups (P<0.05),and the remaining indicators had no significant differences. The results of correlation analysis between FPG,HbA1c values and cardiac function indicators showed that HbA1c,FPG,LVED,and a were positively correlated (P<0.05),HbA1c,FPG,and LVEF were negatively correlated (P<0.05),and HbA1c was correlated with E/A showed a significant negative correlation (P<0.01). The binary logistic regression analysis predicts that the incidence of abnormal left ventricular systolic function was related to whether or not to take Chinese patent medicine adjuvant therapy,gender,HbA1c,and had nothing to do with other factors. [Conclusion] FPG and HbA1c were significantly related to cardiac function. Chinese patent medicine combined with western medicine treatment can effectively reduce the levels of FPG and HbA1c in patients with coronary heart disease and angina pectoris. At higher levels of FPG,Chinese patent medicine combined with western medicine treatment could significantly improve patients' LVED and LVEF. The treatment of coronary heart disease with Chinese patent medicine could reduce the incidence of abnormal left ventricular systolic function.