摘要
目的研究急性心肌梗死(AMI)患者糖化血红蛋白(HbA1c)水平与经皮冠状动脉介入治疗(PCI)术后支架内狭窄严重程度的相关性。方法抽取2017年1月至2019年12月河南大学第一附属医院收治的AMI患者120例为研究对象,均接受PCI治疗,根据术后是否出现支架内再狭窄分为再狭窄组(32例)和未再狭窄组(88例),比较两组一般资料;根据术前检测HbA1c水平将患者分为A组(HbA1c<6.5%,56例)和B组(HbA1c≥6.5%,64例),比较A、B组AMI患者术后再狭窄率、冠状动脉狭窄程度分级情况、最小管腔面积、新生内膜面积、斑块负荷值,并分析HbA1c水平与新生内膜面积、斑块负荷及冠状动脉狭窄程度分级的关系。结果120例AMI患者PCI术后再狭窄32例(26.67%),再狭窄组吸烟比例、HbA1c水平及Gensini评分[23/32、(6.49±1.05)%、(25.76±3.84)分]高于未再狭窄组[45/88、(5.43±0.85)%、(6.25±1.78)分],P<0.05。A组再狭窄率(17.86%,10/56)低于B组(34.38%,22/64),最小管腔面积[(7.18±1.24)mm^2]大于B组[(5.25±1.04)mm^2],新生内膜面积及斑块负荷[(1.05±0.14)mm^2、(42.37±3.65)%]小于B组[(2.28±0.36)mm^2、(57.22±5.19)%],P均<0.05。A、B两组PCI术后支架内狭窄程度分级比较差异有统计学意义(P<0.05);不同支架内狭窄程度分级患者HbA1c水平比较差异有统计学意义(P<0.05)。HbA1c水平与新生内膜面积、斑块负荷及冠状动脉狭窄程度分级呈正相关(r=0.428、0.624、0.303,P<0.05)。结论HbA1c水平越高,术后再狭窄发生率更高,HbA1c水平与AMI患者PCI术后支架内再狭窄严重程度呈高度正相关。
Objective To investigate the relationship of hemoglobin (HbA1c) level with severity of in-stent restenosis after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI).Methods A total of 120 AMI patients underwent PCI in the First Affiliated Hospital of Henan University from January 2017 to December 2019 were enrolled, and they were divided into two groups according to the onset of in-stent restenosis, restenosis group (n=32) and non-restenosis group (n=88). General data were compared between the two groups. According to the level of HbA1c detected before operation, the patients were divided into group A (HbA1c <6.5%, 56 cases) and group B (HbA1c ≥6.5%, 64 cases). The incidence of restenosis, grade of coronary stenosis, minimum lumen area, neo-intimal area and plaque burden of AMI patients in group A and group B were compared. The relationship of HbA1c level with neo-intimal area, plaque burden and classification of coronary stenosis degree were analyzed.Results The incidence of restenosis of the 120 AMI patients after PCI was 26.67% (32/120). The smoking proportion, HbA1c level and Gensini score of restenosis group were 23/32, (6.49±1.05)%, 25.76±3.84, which were higher than the 45/88, (5.43±0.85)%, 6.25±1.78 of non-restenosis group (P<0.05). The incidence of restenosis in group A (17.86%, 10/56) was lower than that in group B (34.38%, 22/64), P<0.05;the minimum lumen area in group A was (7.18±1.24)mm^2, larger than the (5.25±1.04)mm^2 in group B, and the neo-intimal area and plaque burden in group A were (1.05±0.14)mm^2 and (42.37±3.65)% respectively, which were smaller than the (2.28±0.36)mm^2 and (57.22±5.19)% in group B (P<0.05). The in-stent restenosis rate after PCI had significant difference between group A and group B (P<0.05);there was a significant difference in HbA1c level in patients with different degrees of in-stent stenosis (P<0.05). HbA1c levels were positively correlated with neo-intimal area, plaque burden and coronary stenosis degree (r=0.428, 0
作者
王东方
滕伟
王鲜花
Wang Dongfang;Teng Wei;Wang Xianhua(Department of Cardiology,the First Affiliated Hospital of Henan University,Kaifeng 475000,China;Department of Cardiology,Lankao Traditional Chinese Medicine Hospital,Kaifeng 475300,China)
出处
《中国实用医刊》
2020年第13期33-36,共4页
Chinese Journal of Practical Medicine
