發(fā)布時(shí)間：2018-09-11 13:34

【摘要】：目的探索糖化血紅蛋白(HbA1c)與急性心肌梗死(AMI)經(jīng)皮冠狀動(dòng)脈介入(PCI)術(shù)后無(wú)復(fù)流危險(xiǎn)因素相關(guān)性。方法接受PCI的AMI患者中術(shù)后無(wú)復(fù)流65例為觀察組,術(shù)后血流正常灌注135例為對(duì)照組。結(jié)果兩組梗死前心絞痛史(χ~2=4.179,P=0.041)、術(shù)前心肌梗死溶栓(TIMI)血流分級(jí)(χ~2=7.729,P=0.005)差異顯著(P0.05);兩組血清中總膽固醇(TG)(t=1.146,P=0.253)、甘油三酯(TC)(t=1.017,P=0.310)、高密度脂蛋白膽固醇(HDL-C)(t=1.594,P=0.113)、低密度脂蛋白膽固醇(LDL)-C(t=0.746,P=0.456)、白細(xì)胞計(jì)數(shù)(WBC)(t=0.975,P=0.331)、肌鈣蛋白(c Tn I)(t=0.684,P=0.495)、肌酸激酶同工酶(t=0.958,P=0.339)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);觀察組HbA1c水平高于對(duì)照組(t=2.467,P=0.015);不同HbA1c濃度的兩組患者在糖尿病史、HbA1c、心功能Killip分級(jí)、左室室射血分?jǐn)?shù)(LVEF)水平具有統(tǒng)計(jì)學(xué)差異(P0.05);運(yùn)用Logistic回歸分析方法分析兩組HbA1c升高組PCI術(shù)后無(wú)復(fù)流危險(xiǎn)因素發(fā)現(xiàn),糖尿病史、梗死前心絞痛、術(shù)前TIMI血流分級(jí)、HbA1c、LVEF水平是AMI HbA1c升高組PCI術(shù)后無(wú)復(fù)流的獨(dú)立危險(xiǎn)因素。結(jié)論 HbA1c升高PCI術(shù)無(wú)復(fù)流患者心肌收縮功能受限進(jìn)一步影響左心室收縮功能。糖尿病史、梗死前心絞痛、術(shù)前TIMI血流分級(jí)增加、HbA1c水平升高、左室功能受損是AMI HbA1c升高組患者PCI術(shù)后無(wú)復(fù)流的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective to investigate the correlation between glycosylated hemoglobin (HbA1c) and no reflow risk factors after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Methods 65 patients with AMI who received PCI were treated as observation group and 135 patients with normal blood flow as control group. Results the history of pre-infarction angina pectoris (蠂 ~ 2 / 24.179 / P0.041), preoperative thrombolytic (TIMI) grade (蠂 ~ (2 +) 7.729 / P ~ (0.005), serum total cholesterol (TG) (1.146), triglyceride (TC) () t1.017 (0.310), high-density lipoprotein cholesterol (HDL-C) (t _ (1.594) P _ (0.113), low density lipoprotein cholesterol (LDL) _ C (t _ (0.746P _ (0.456), leucocyte count) were significantly different between the two groups (P0.05). There was no significant difference in the number of (WBC) (t0. 975 (P < 0. 331), troponin (c Tn I) (0. 684) P0. 495), creatine kinase isoenzyme (t0. 958% P0. 339) (P0.05), the level of HbA1c in the observation group was higher than that in the control group (t = 2. 467 P0. 015), there was no significant difference between the two groups in the history of diabetes mellitus (HbA1c., Killip grade), there was no significant difference between the two groups (P0. 015). There was significant difference in left ventricular ejection fraction (LVEF) between the two groups (P0.05). The results of Logistic regression analysis showed that there were no risk factors of reflow after PCI in the two groups of HbA1c elevation group, diabetes history, angina pectoris before infarction, Preoperative TIMI blood flow grade and HbA1cU LVEF level were independent risk factors for no reflow after PCI in patients with elevated AMI HbA1c. Conclusion the left ventricular systolic function is further affected by the increase of HbA1c in patients without reflow after PCI. Diabetes history, pre-infarction angina pectoris, increased preoperative TIMI blood flow grade and increased HBA _ 1c level, left ventricular dysfunction were independent risk factors for no reflow after PCI in patients with elevated AMI HbA1c.
【作者單位】： 滄州市人民醫(yī)院;
【分類號(hào)】：R542.22

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