本文選題：冠心病 + 糖尿病　； 參考：《重慶醫(yī)學(xué)》2017年22期

【摘要】：目的分析冠心病(CHD)合并糖尿病(DM)患者11脫氫血栓素B2/6-酮前列環(huán)素比值(11-dh-TXB2/6-k-PGF1a,dTP)及與主要不良心血管事件(MACE)和再住院之間的關(guān)系。方法選擇2013年7月至2014年6月270例CHD患者作為研究對(duì)象,其中136例非DM患者(非DM組),134例合并DM患者(DM組)。記錄患者臨床情況,測(cè)量身高、體質(zhì)量、血壓、心率等指標(biāo),完善心電圖、超聲心動(dòng)圖、冠狀動(dòng)脈造影等檢查。測(cè)定兩組患者11-dh-TXB2和6-k-PGF1a水平,計(jì)算dTP值。隨訪(fǎng)1年,記錄患者M(jìn)ACE事件及再次住院情況。Epdate軟件建庫(kù),SPSS 17.0軟件進(jìn)行統(tǒng)計(jì)分析。結(jié)果非DM組與DM組dTP分別為1.8±0.6和2.0±0.7,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)于非DM組,hs-CRP、收縮壓、舒張壓、冠狀動(dòng)脈病變數(shù)及嚴(yán)重病變數(shù)與dTP相關(guān)(P0.05)。而對(duì)于DM組,hs-CRP、血糖、膽固醇水平、冠狀動(dòng)脈病變數(shù)及嚴(yán)重病變數(shù)與dTP相關(guān)(P0.05)。隨訪(fǎng)1年,非DM組和DM組患者發(fā)生MACE事件分別為33例(24.3%)和44例(32.8%),兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。非DM組和DM組再次住院患者分別為12例(8.8%)和24例(17.9%),兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。發(fā)生MACE的患者與無(wú)MACE的患者住院時(shí)dTP分別為2.3±0.8和1.8±0.6,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。再住院患者與未再住院組患者住院時(shí)dTP分別為2.4±1.0和1.9±0.6,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 CHD合并DM患者dTP明顯增高,提示血小板明顯活化,且較高的dTP增加了患者M(jìn)ACE事件及再次住院風(fēng)險(xiǎn),應(yīng)該強(qiáng)化抗血小板治療。
[Abstract]:Objective to analyze the relationship between 11 dehydrothromboxane B 2 / 6 keto-prostacyclin ratio (11-dh-TXB 2 / 6-k-PGF1aTTP) and major adverse cardiovascular events (Mace) and rehospitalization in patients with coronary heart disease (CHD) and diabetes mellitus (DM). Methods from July 2013 to June 2014, 270 patients with CHD were selected as study subjects, including 136 non-DM patients (non-DM group) and 134 patients with diabetes mellitus (DM group). Record the clinical condition, measure the height, body mass, blood pressure, heart rate, perfect electrocardiogram, echocardiography, coronary angiography and so on. The levels of 11-dh-TXB2 and 6-k-PGF1a were measured and the dTP values were calculated. All patients were followed up for 1 year to record Mace events and re-hospitalization. SPSS 17.0 software was used to analyze the data set up by Epdate software. Results the dTP of non-DM group and DM group were 1.8 鹵0.6 and 2.0 鹵0.7, respectively. The difference was statistically significant (P0.05). In non-DM group, systolic blood pressure, diastolic blood pressure, number of coronary artery lesions and the number of severe lesions were correlated with dTP (P0.05). In DM group, the levels of hs-CRP, blood glucose, cholesterol, the number of coronary artery lesions and the number of severe lesions were correlated with dTP (P0.05). After 1 year follow-up, 33 cases (24.3%) and 44 cases (32.8%) had Mace events in non-DM group and DM group, respectively. There was no significant difference between the two groups (P0.05). There were 12 cases (8.8%) and 24 cases (17.9%) in non-DM group and DM group, respectively. The difference between the two groups was statistically significant (P0.05). The DTP of patients with Mace and those without Mace were 2.3 鹵0.8 and 1.8 鹵0.6, respectively. The difference was statistically significant (P0.05). DTP was 2.4 鹵1.0 and 1.9 鹵0.6 in the re-hospitalized group and the non-re-hospitalized group, respectively. The difference was statistically significant (P0.05). Conclusion the increase of dTP in CHD patients with DM suggests that platelet activation and high DTP increase the risk of Mace events and re-hospitalization in patients with CHD and diabetes mellitus, so antiplatelet therapy should be strengthened.
【作者單位】： 華北理工大學(xué)附屬醫(yī)院心血管內(nèi)科;華北理工大學(xué)校醫(yī)院;
【基金】：河北省衛(wèi)生廳醫(yī)學(xué)研究重點(diǎn)課題計(jì)劃項(xiàng)目(20100474)
【分類(lèi)號(hào)】：R541.4;R587.1

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