文章摘要
程昭栋,杨体霞,周利民,张军,王三刚,李峰.糖化血红蛋白水平对急性ST段抬高型心肌梗死患者住院期间及近期预后的影响[J].中国临床保健杂志,2018,21(3):345-348.
糖化血红蛋白水平对急性ST段抬高型心肌梗死患者住院期间及近期预后的影响
Influence of glycosylated hemoglobin level on in-hospital and short-term prognosis of patients with STEMI
投稿时间:2017-08-10  
DOI:10.3969/J.issn.1672-6790.2018.03.016
中文关键词: 心肌梗死  糖化血红蛋白  预后
英文关键词: Myocardial infarction  Glycosylated hemoglobin  Prognosis 〖FL
基金项目:
作者单位E-mail
程昭栋 安徽滁州市第一人民医院心血管内科,239000 chengzhaodong2007@126.com 
杨体霞 安徽滁州市第一人民医院心血管内科,239000  
周利民 安徽滁州市第一人民医院心血管内科,239000  
张军 安徽滁州市第一人民医院心血管内科,239000  
王三刚 安徽滁州市第一人民医院心血管内科,239000  
李峰 安徽滁州市第一人民医院心血管内科,239000  
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中文摘要:
      目的 评价糖化血红蛋白(HbA1c)水平对急性ST段抬高型心肌梗死(STEMI)患者住院期间及出院30 d左心室射血分数(LVEF)的影响。方法 选取诊断为STEMI的患者121例作为研究对象,所有研究对象均行冠状动脉造影检查,根据HbA1c水平分为HbA1c升高组(51例)和HbA1c正常组(70例)。测量HbA1c水平,记录患者冠状动脉造影结果、肌钙蛋白峰值、B型钠尿肽(BNP)峰值、住院期间主要心血管不良事件(MACE)、住院时间及出院30 d后的LVEF,对比两组以上各指标的情况,分析糖化血红蛋白HbA1c水平对STEMI患者住院期间及近期预后的影响。结果 HbA1c升高组在双支或三支病变的发生率较HbA1c正常组高,差异有统计学意义(P<0.05);HbA1c正常组中局限性狭窄发生率[32例(45.7%)]较HbA1c升高组[6例(11.8%)]高,差异有统计学意义(χ2=15.786,P<0.001),而弥漫性狭窄在HbA1c升高组更为常见,差异有统计学意义(P<0.05)。两组B型钠尿肽(BNP)峰值和出院30天LVEF相比,差异有统计学意义(均P<0.05)。HbA1c升高组住院时间长于HbA1c正常组,差异有统计学意义(P<0.05);两组患者住院期间肌钙蛋白峰值和MACE的发生率差异无统计学意义(均P>0.05)。结论 HbA1c水平升高是导致STEMI患者发生复杂冠状动脉病变的重要因素,并可以导致患者心功能恶化,延长患者住院时间,进而影响近期预后。
英文摘要:
      Objective To evaluate the influence of glycosylated hemoglobin (HbA1c) level on in-hospital and 30 days prognosis of patients with ST-elevation myocardial infarction (STEMI).Methods 121cases of diagnosed STEMI by coronary angiography were divided into two groups according to the level of glycosylated hemoglobin:higher glycosylated hemoglobin group(n=51) and normal glycosylated hemoglobin group(n=70).Glycosylated hemoglobin level,coronary angiography,the peak of troponin concentration,the peak value of plasma brain natriuretic peptide(BNP),main adverse cardiac events(MACE),hospitalization time and LVEF of 30 days post-discharge were measured and recorded.Influence of glycosylated hemoglobin level on in-hospital and short-term prognosis of patients with STEMI were analyzed according to the index above.Results Higher glycosylated hemoglobin group had significant higher incidence rate compared with the normal glycosylated hemoglobin group in the double branch lesions and three branch lesions in the patients with STEMI(P<0.05).Significant difference was found between normal glycosylated hemoglobin group and higher glycosylated hemoglobin group in the incidence of localized stenosis(P<0.05).Higher glycosylated hemoglobin group was significantly higher than in normal glycosylated hemoglobin group in the incidence of diffused stenosis(P<0.05).Significant difference was found between normal glycosylated hemoglobin group and higher glycosylated hemoglobin group on the BNP peak and LVEF of 30 days(P<0.05).In comparison,the higher glycosylated hemoglobin group had longer hospital stay than normal glycosylated hemoglobin group(P<0.05).There were no significant difference between normal glycosylated hemoglobin group and higher glycosylated hemoglobin group in the peak of troponin concentration and MACE(P>0.05).Conclusions Elevated HbA1c level is an important factor leading to complex coronary artery lesions,and can lead to the deterioration of heart function with prolonged hospitalization time,thereby affecting the short-term prognosis in patients with STEMI.
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