摘要
目的探讨糖化血红蛋白(HbA1c)与急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后心功能的关系。方法选择2009年发病时间<12 h的因AMI行PCI患者324例,根据入院时HbA1c水平分为HbA1c升高组(HbA1c≥6.5%,123例)和对照组(HbA1c<6.5%,201例),对比分析两组患者心功能的差异。结果两组患者术前TIMI血流0级率间差异无统计学意义(P>0.05)。两组病变血管支数、冠状动脉梗死相关血管开通时间和无复流发生率比较,差异均无统计学意义(P>0.05)。两组患者住院期间左室射血分数(LVEF)和心力衰竭发生率间差异均无统计学意义(P>0.05)。两组PCI后3个月时LVEF和心力衰竭发生率间差异均有统计学意义(P<0.05)。多因素分析结果显示,在校正了其他危险因素之后,HbA1c是PCI后3个月时心力衰竭发生的影响因素〔OR=2.978,95%CI(1.635,5.018),P=0.021〕。结论 HbA1c升高是AMI患者心功能差的影响因素,应重视HbA1c在AMI预后中的作用,早期干预,控制血糖。
Objective To investigate the relationship between HbAlo and heart function in patients with acute myocardial infarction （AMI） who undergoing primary percutaneous coronary intervention （PCI）. Methods In 2009, 324 AMI patients undergoing primary PCI were enrolled in this study. According to the level of HbA1c, the patients were divided into high HbA1c group （ HbA1c〉6. 5% ） and control group （ HbA,o 〈 6. 5% ）, and the heart function were analyzed. Results Thrombolysis in myocardial infarction （TIMI） flow grade 0 was not significantly different between these two groups before PCI （P 〉0. 05）. The number of injured blood vessels, reperfusion time of infarct - related artery （ IRA）, and no - flow phenomena were not significantly different （P 〉 0. 05）. The left ventricular ejection fraction （LVEF） and incidences of heart failure during hospital stay showed no significant differences （P 〉 0. 05） but were significantly different three months after PCI （P 〈 0. 05 ）. As shown in multivariate analysis, after the other risk factors were adjusted, HbA,o I〉6. 5% was a predictor of heart failure three months after PCI [ OR = 2. 978, 95% CI （ 1. 635, 5.018）, P = 0. 021 ]. Conclusion The increased HbA,o level is a influencing factors of poor heart failure in AMI patients 3 month after PCI.HbA1c may be a useful indicator for the early intervetnion of AMI and blood sugar control.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第2期151-153,共3页
Chinese General Practice
关键词
急性心肌梗死
血管成形术
经腔
经皮冠状动脉
血红蛋白A
糖基化
心功能
Acute myocardial infarction
Angioplasty, transluminal, percutaneous coronary
Hemoglobin A, glycosylated
Heart function
