摘要
目的:探讨糖尿病并发心肌梗死患者糖化血红蛋白(HbA1c)水平和预后心功能的相关性。方法:选取2020年1月—2022年6月住院就诊治疗的心电图ST段抬高型心肌梗死患者(100例),根据患者HbA1c水平分为对照组32例(HbA1c<6.5%)和观察组68例(HbA1c≥6.5%)。出院前对2组患者进行血清指标检测,包括高密度脂蛋白胆固醇(HDL-C)、高敏C反应蛋白(Hs-CRP)、低密度脂蛋白胆固醇(LDL-C)及甘油三酯(TG)。统计患者住院期间的不良发生率。比较分析2组患者住院期间、出院时及出院后3个月的左室射血分数(LVEF)。2组患者均随访2年,计算心肌梗死复发率和病死率。结果:观察组较对照组心功能分级较差(P<0.05)。观察组与对照组HDL-C、Hs-CRP、LDL-C比较差异无统计学意义,且观察组TG水平高于对照组(P<0.05)。观察组不良发生率较对照组升高(P<0.05)。2组患者入院、出院时LVEF无明显差异。观察组患者出院3个月后LVEF明显低于对照组(P<0.05)。观察组较对照组的心肌梗死复发率和病死率在2年内升高(P<0.05)。结论:HbAlc水平升高影响糖尿病并发心肌梗死患者心脏不良事件发生率,降低患者的预后生存率,患者必须积极地控制血糖,有助于预防糖尿病和心血管病。
Objective To explore the relationship between glycosylated hemoglobin level and prognosis of cardiac function in the patients with diabetes complicated with myocardial infarction.Methods ST segment elevation myocardial infarction (STEMI) patients who were hospitalized between January 2020 and June 2022 were selected, and divided into a control group of 32 cases(HbA1c < 6.5%) and an observation group of 68 cases(HbA1c≥6.5%) based on their HbA1c levels. Before discharge, serum indexes of the two groups of patients were tested, including high-density lipoprotein cholesterol(HDL-C), high-sensitivity C-reactive protein(Hs-CRP), low-density lipoprotein cholesterol(LDL-C) and triglyceride(TG). The incidence of adverse events during patient hospitalization was calculated. The LVEF of two groups of patients during hospitalization, at discharge, and 3 months after discharge was compared and analyzed. Both groups of patients were followed up for 2 years to calculate the recurrence rate and mortality of myocardial infarction.Results The classification of cardiac function in the observation group was worse than that in the control group(P < 0.05). There was no difference in HDL-C, hs-CRP and LDL-C between the observation group and the control group, and the TG level in the observation group was higher than that in the control group(P < 0.05). The incidence of adverse events in the observation group was higher than that in the control group(P < 0.05). There was no difference in LVEF between the two groups at the time of admission and discharge, but the LVEF of the observation group was lower than that of the control group at the third month after discharge(P < 0.05). The recurrence rate and mortality of myocardial infarction in the observation group were higher than those in the control group within two years(P < 0.05).Conclusion The increased level of HbAlc may affect the incidence of adverse cardiac events in the patients with diabetes complicated with myocardial infarction, and reduce the prognostic survival rate of patie
作者
卓雪芽
庄健海
蔡惠兴
谭顺莲
ZHUO Xueya;ZHUANG Jianhai;CAI Huixing;TAN Shunlian(Department of Medical Laboratory Center,Foshan Hospital of Traditional Chinese Medicine,Foshan,528000,China)
出处
《临床血液学杂志》
2023年第10期702-706,共5页
Journal of Clinical Hematology
关键词
糖尿病
心肌梗死
糖化血红蛋白
心功能分级
diabetes
myocardial infarction
glycated hemoglobin
cardiac function classification
