摘要
目的分析经皮冠状动脉介入术(PCI)后血糖变化情况及影响因素。方法选取2014年11月至2018年11月期间于承德医学院附属医院进行PCI手术治疗的226例冠心病患者(非糖尿病)为研究对象,根据PCI术后患者是否出现应激性血糖升高分为高血糖组(空腹血糖≥7 mmol/L)和非高血糖组(空腹血糖<7 mmol/L),对比两组患者的基线资料和术前(t0)、术后1 h(t1)、术后2 h(t2)的血糖水平,并应用单因素和多因素Logistic回归模型分析PCI术后血糖变化的影响因素。结果226例患者中有165例出现应激性血糖升高,发生率为73.01%;两组患者在性别、梗死类型、置入支架的血管数、高血压、高血脂等因素均无统计学差异(P>0.05);但高血糖组患者年龄、体质量指数(BMI)、支架数量、支架直径、支架长度高于非高血糖组,且高血糖组患者的心功能Killip分级、糖化血红蛋白水平≥6.5%的发生率高于非高血糖组,差异具有统计学意义(t/χ2=6.105、15.641、19.116、13.015、5.294、15.180、46.443,P<0.05);两组患者t1、t2时血糖水平高于t0,t2时血糖水平高于t1,且高血糖组患者的血糖水平明显高于非高血糖组,差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示BMI≥25 kg/m2、支架数量≥3个、Killip分级≥Ⅱ级、糖化血红蛋白水平≥6.5%为PCI术后血糖异常发生的独立危险因素(OR=13.411、2.894、9.202、11.699,P<0.01)。结论PCI术后血糖异常与年龄、BMI、支架数量、Killip分级、糖化血红蛋白水平具有临床相关性,且BMI、支架数量、Killip分级、糖化血红蛋白水平是PCI术后血糖异常发生的独立危险因素。
Objective To analyze changes and influencing factors of blood glucose after percutaneous coronary intervention(PCI).Methods 226 patients with coronary heart disease(nondiabetes)who underwent PCI surgery at affiliated hospital of Chengde medical college from November 2014 to November 2018 were selected as subjects.According to whether patients had stress-induced hyperglycemia after PCI,patients were divided into hyperglycemia group(fasting blood glucose≥7 mmol/L)and non-hyperglycemia group(fasting blood glucose<7 mmol/L).Baseline data and the blood glucose levels at pre-operation(t0),1 h after surgery(t1),and 2 h after surgery(t2)were compared between the two groups.Univariate and multivariate logistic regression models were used to analyze the influencing factors of blood glucose changes after PCI.Results Among the 226 patients enrolled in the study,165 patients had stress-induced hyperglycemia with an incidence of 73.01%.There were no statistically significant differences in gender,type of myocardial infarction,number of vessels placed stent,hypertension,and hypercholesterolemia between the two groups(P>0.05).However,age,body mass index(BMI),number of stents,stent diameter and stent length in the hyperglycemia group were higher than those in the non-hyperglycemia group.The incidences of Killip grade and glycosylated hemoglobin level≥6.5%in patients with hyperglycemia were higher than that in non-hyperglycemia group,the differences were statistically significant(t/χ2=6.105,15.641,19.116,13.015,5.294,15.180,46.443,P<0.05).The blood glucose levels at t1 and t2 were higher than t0,the blood glucose level at t2 was higher than t1,and the blood glucose level in the hyperglycemia group was significantly higher than that in the non-hyperglycemia group,the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that BMI≥25 kg/m2,number of stents≥3,Killip classification≥II,glycosylated hemoglobin level≥6.5%were independent risk factors for abnormal blood glucose after
作者
胡娜
田雅楠
胡舒环
黄贤胜
Hu Na;Tian Yanan;Hu Shuhuan;Huang Xiansheng(Cardiology,Affiliated Hospital of Chengde Medical University,Chengde 067000,China;Geriatrics Department,Affiliated Hospital of Chengde Medical University,Chengde 067000,China)
出处
《心脑血管病防治》
2020年第4期372-374,379,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
基金
河北省承德市科学技术研究与发展计划项目(201706A048)。
