贵州医科大学学报

2015, v.40;No.172(01) 104-106

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HbA1c水平对PCI术后冠心病伴糖尿病患者心血管不良事件的影响
The Effect of Hb A1c Level on the Incidence of MACE in Postoperative Patients of CHD & DM after PCI Therapy

李源;房卿;周庆元;
LI Yuan;FANG Qing;ZHOU Qingyuan;Pneumology Department,3201 Hospital of Zhonghang Industry;

摘要(Abstract):

目的:探讨糖化血红蛋白(Hb A1c)水平与经皮冠状动脉介入治疗(PCI)术后冠心病(CHD)伴糖尿病患者心血管不良事件(MACE)发生率的关系。方法:行PCI治疗的CHD患者83例,根据入组患者的Hb A1c水平将其分为A、B两组,A组(Hb A1c<6.5%)38例,B组(Hb A1c≥6.5%)45例,比较两组患者资料、术前术前C反应蛋白(CRP)、血沉(ESR)、肿瘤坏死因子(TNF-α)及白介素6(IL-6)水平、观察2组经PCI治疗后6和24月MACE发生率。结果:A组患者术前的CRP、TNF-α水平均显著低于B组(t=5.944、5.095,P<0.01),两组ESR及IL-6差异无统计学意义(P>0.05);治疗6月后,A、B两组患者MACE结果差异无统计学意义(P>0.05);治疗24月后A组患者出现心梗、病变血管再狭窄的比例均低于B组,差异有统计学意义(χ2=5.385、6.629,P=0.020、0.010)。结论:PCI术后,与高Hb A1c患者比较,Hb A1c水平低的CHD伴糖尿病患者的预后较好。
Objective: To explore the relationship of Hb A1 c level with the incidence of adverse cardiovascular events( MACE) of CHD & DM patients after PCI therapy. Methods: Eighty-three cases of CHD & DM patients after PCI operation were selected and divided into group A( Hb A1 c < 6. 5%) and group B( Hb A1c≥6. 5%),with 38 cases in group A and 45 in group B. The preoperative CRP,ESR,TNF-α IL-6 in group A and group B were compared and MACE incidences were observed in 6months and 24 months after PCI respectively. Results: The preoperative average CRP and TNF-α levels in group A were obviously higher than those in group B( t = 5. 944,5. 095,P < 0. 01),but the differences of ESR and IL-6 levels were not significant between groups A and B. The MACE incidence in 6 months after PCI therapy was not significantly different between groups A and B( P > 0. 05); But in 24 months after PCI therapy,the proportion of myocardial infarction and vascular restenosis in the patients in group A was significantly lower than that in group B( χ2= 5. 385,6. 629; P = 0. 020,0. 010). Conclusion: After PCI therapy,the prognosis of CHD & DM patients with lower Hb A1 c level is better than that of patients with higher Hb A1 c level.

关键词(KeyWords): 冠心病;糖尿病;心血管疾病;糖化血红蛋白;经皮冠状动脉介入
coronary heart disease;diabetes mellitus;cardiovascular diseases;Hb A1c;percutaneous coronary intervention

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作者(Author): 李源;房卿;周庆元;
LI Yuan;FANG Qing;ZHOU Qingyuan;Pneumology Department,3201 Hospital of Zhonghang Industry;

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DOI: 10.19367/j.cnki.1000-2707.2015.01.028

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